| NPI | 1427083534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOARMAN Billing Manager 270-926-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-08-06 |