| NPI | 1710791504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIE NOBLE Authorized Official / Owner 330-550-2559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2025-02-03 |
| Last Update Date | 2025-08-07 |