| NPI | 1740920123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA BUTLER Owner 228-697-4567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-02-24 |