| NPI | 1699067488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATARA S CHAVIS President 910-521-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005148) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2017-03-07 |