| NPI | 1487140265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE NORTHAM CEO 712-828-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 176B00000X Midwife (Licence: ID CNM81-A) |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2024-11-04 |