| NPI | 1699416636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVANTI CROSS-BROWN Pmhnp 731-228-9068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-08-14 |