| NPI | 1417361247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA PHILLIPS Business Office Manager 870-394-4387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-06-19 |