NPI | 1639587728 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBBIE C. SHENEMAN Owner 941-920-2842 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 2221632) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
Enumeration Date | 2014-08-01 |
Last Update Date | 2020-03-06 |