| NPI | 1427836220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL I CHRISTIAN Owner/ Nurse Practitioner 386-348-1158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2024-01-13 |