| NPI | 1679232524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SUMBLER Owner/Authorized Official 318-229-2215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2022-11-21 |