| NPI | 1689192437 |
|---|---|
| Doing Business As | PINE RIDGE FAMILY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | LAURIE SODAMANN Health Services Administrator 785-783-8453 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-46075) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-12-28 |