| NPI | 1518347038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CROKER Owner 386-473-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP3333802) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2020-08-12 |