| NPI | 1558041061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYRA COOKE Member 317-443-8172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2024-02-20 |