| NPI | 1508582289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHENA CLARE FERTIG President/Treasurer 712-266-3577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2022-10-14 |