| NPI | 1518746262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LYNN LAWS Owner 870-639-1503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-05-06 |