NPI | 1770626152 |
---|---|
Doing Business As | SOUTHERN INDIANA FAMILY PRACTICE CENTER |
Entity Type | Organization |
Authorized Contact | KAREN L. REID-RENNER Owner 812-339-6744 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IN 01055670A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002130A) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2015-11-20 |