| NPI | 1457845653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN G FLETCHER DEPREE Director/Practitioner 774-255-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2019-10-04 |