| NPI | 1770365843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA KATHERINE COAKLEY Owner/Provider 563-357-3061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-10-13 |
| Last Update Date | 2023-10-25 |