| NPI | 1417480161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CHITSEY Owner 870-365-7441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AR A01409) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2022-08-30 |