| NPI | 1598644700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CASEY JONES Owner 870-378-1876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-09-01 |
| Last Update Date | 2025-09-01 |