| NPI | 1720997307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAKISHA A GODFREY Owner, Advanced Practice Reg. Nurse 800-711-9373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2026-09-01 |
| Last Update Date | 2026-09-01 |