| NPI | 1538605324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARISSA RENAE LUKING Fnp C/Owner 812-316-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004665A) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2018-03-26 |