| NPI | 1659169175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE NOBLES Billing Manager 478-953-0024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2025-04-25 |
| Last Update Date | 2025-07-21 |