| NPI | 1467957126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM V CAICEDO Np 731-518-7391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17787) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2019-02-08 |