NPI | 1518468966 |
---|---|
Entity Type | Organization |
Authorized Contact | KAREN JACKSON Owner 850-290-8410 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 207R00000X Internal Medicine |
363AM0700X Physician Assistant, Medical | |
363LA2200X Nurse Practitioner, Adult Health | |
Enumeration Date | 2018-02-21 |
Last Update Date | 2023-06-23 |