| NPI | 1740858950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN SWANSEN Owner 888-709-8721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |