| NPI | 1588433726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER CHARLES Admin Assist/Billing 928-247-9277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2025-01-16 |