| NPI | 1790506442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNICA ANDERSON Owner 347-926-3188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2025-12-16 |