| NPI | 1649656190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA WARNER Owner Provider 918-740-3199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2021-09-08 |