| NPI | 1629901269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JEGASOTHY Incorporator 412-647-5472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 208000000X Pediatrics |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 207Q00000X Family Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 163WP0200X Registered Nurse, Pediatrics | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2026-06-04 |
| Last Update Date | 2026-06-04 |