| NPI | 1790648632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYCOLE ASHLEY COX Nurse Practitioner 943-200-4073 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2026-07-10 |