NPI | 1750746459 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY LYNN RINES Owner 712-629-0040 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IA H131507) |
Enumeration Date | 2015-12-22 |
Last Update Date | 2015-12-22 |