| NPI | 1386787224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE DENISE CARSON Owner 706-638-4979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 329537-22) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |