| NPI | 1750991709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIA ROLLINS-MUSGRAVE Owner 667-720-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| 251S00000X | |
| 291U00000X Clinical Medical Laboratory | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-09-28 |