NPI | 1740061886 |
---|---|
Doing Business As | PRODIGY HEALTH & WELLNESS PLLC |
Entity Type | Organization |
Authorized Contact | LISA P. BLEVINS Nurse Practitioner 919-793-6483 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2023-10-12 |
Last Update Date | 2023-10-12 |