| NPI | 1568933216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KAILEE WHITE Family Nurse Practitioner 386-506-2992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |