| NPI | 1699608380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2026-06-04 |
| Last Update Date | 2026-06-04 |