| NPI | 1699008391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY KAY COBB Owner/Provider 479-462-8043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 66821) |
| Enumeration Date | 2009-09-12 |
| Last Update Date | 2018-09-21 |