| NPI | 1750986626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERRILL ELIZABETH HOOVER Owner/Provider 620-236-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2021-03-31 |