| NPI | 1447503685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDA DIXON Nurse Practitioner 270-827-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007749) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2013-05-06 |