NPI | 1720226236 |
---|---|
Entity Type | Organization |
Authorized Contact | PETINA ANN SLOAN Practice Administrator 910-246-2229 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 20070048) |
Enumeration Date | 2009-01-22 |
Last Update Date | 2021-08-23 |