| NPI | 1689389595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN SKEWIS Np 906-236-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-05-23 |