| NPI | 1770054223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA T MONTELLANO Owner 360-298-8044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2023-01-05 |