| NPI | 1477210532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA WARDLOW RN Fa 267-784-1014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2021-11-23 |