| NPI | 1487391462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNAH B BARLOW Owner 318-414-2315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-12-09 |