| NPI | 1639044431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEYSHA PATRICE FREENY Nurse Practitioner 219-306-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-10-09 |
| Last Update Date | 2025-10-20 |