| NPI | 1508613886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JOY VP Alliance Management 667-218-3396 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |