| NPI | 1699233890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA HEARD Np 334-275-7658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2024-03-26 |