| NPI | 1720341514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN T HART Practice Manager 912-871-4847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN104429) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-06-18 |