| NPI | 1396256426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE CAMILLE ONEAL BREWINGTON Nurse Practitioner 336-282-1251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 201644) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201644) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2023-09-08 |