| NPI | 1609570563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN WARE Owner 606-448-0693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 364SH0200X Clinical Nurse Specialist, Home Health |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |