| NPI | 1780208686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANNESSA DAVIS Np 603-601-4766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 208D00000X General Practice |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2021-12-28 |