| NPI | 1578224671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA JEFFERIES Owner 385-352-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-01-01 |
| Last Update Date | 2023-03-01 |