| NPI | 1508215963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA EDGE GIBSON Nurse Practitioner/Owner 910-506-4510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 183257) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2023-01-16 |