| NPI | 1689323511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DAY NICHOLSON Provider/Owner 984-288-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2024-01-23 |