| NPI | 1508681149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA NGANGA Fnp 913-207-9410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2024-11-19 |