| NPI | 1730988155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHON EDWARD BLUM Psychiatric Nurse Practitioner 907-433-9358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-07-29 |