| NPI | 1386319440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-11 |