| NPI | 1417516006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALANDRIA M GURLEY Nurse Practitioner Owner 176-916-7687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-06-05 |