| NPI | 1376796201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY TERESA STEWART-DIXON Owner 318-325-0325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP04140) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2010-02-16 |