| NPI | 1548077563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAYSIA MILLER Ambr 863-241-3202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LC1500X Nurse Practitioner, Community Health | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2024-12-12 |