NPI | 1558318543 |
---|---|
Entity Type | Organization |
Authorized Contact | LYNN ROBINSON Creditialing 270-259-5641 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
Additional Taxonomies | 208000000X Pediatrics |
363LP0200X Nurse Practitioner, Pediatrics | |
Enumeration Date | 2006-05-27 |
Last Update Date | 2020-10-20 |