NPI | 1700259173 |
---|---|
Entity Type | Organization |
Authorized Contact | JOANNA ROTH Nurse Practitioner 574-891-4920 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002933A) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71002933A) |
363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71002933A) | |
Enumeration Date | 2015-11-07 |
Last Update Date | 2019-09-09 |