| NPI | 1407201197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE ANN CHAUNCY Advanced Nurse Practitioner 903-831-0161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP121596) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126756) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2021-10-11 |