| NPI | 1518798214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYDIA M WHITAKER Owner 723-577-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-26 |