NPI | 1629494265 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE ANN DICKERHOFF Nurse Practitioner, Owner 910-670-2047 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 148570) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 164680) |
Enumeration Date | 2014-03-06 |
Last Update Date | 2014-03-26 |