| NPI | 1588935712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL M ALLEN Owner 850-225-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 1692262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 1692262) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-11-18 |