| NPI | 1457640898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JENKINS VP 270-827-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner Acute Care | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2020-11-17 |