| NPI | 1649901992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA GAIL LEGAULT Owner/Provider 321-312-1494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2024-04-11 |