| NPI | 1376221622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MCCONATHY Co Owner 501-627-5788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-07 |