| NPI | 1619321221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN A YOUNG President / CEO 870-209-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AR A004617) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |