| NPI | 1588618011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC E HINES President/CEO 641-682-4978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-09-11 |