| NPI | 1467917898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MCCORMACK Owner 850-687-0887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2022-12-15 |