| NPI | 1710932256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE MARIE WORTH Assistant Director Of Patient Accou 7702-512-5060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |