| NPI | 1487094223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA BRACKIN Manager 812-405-2125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-10-23 |