| NPI | 1548651128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY S SHUMATE Owner 336-849-4171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 146646) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2019-11-19 |