| NPI | 1396696142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA NICOE MAYWEATHER Nurse Practitioner/Owner 618-500-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2026-02-06 |
| Last Update Date | 2026-02-06 |