| NPI | 1710599089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL JACKSON CEO/Coowner 225-716-5264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |