NPI | 1417714403 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLEY HOCHSTETLER Board President 765-662-7289 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
Enumeration Date | 2024-03-05 |
Last Update Date | 2024-03-05 |