NPI | 1528557840 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
363A00000X Physician Assistant | |
Enumeration Date | 2018-05-02 |
Last Update Date | 2022-07-09 |