NPI | 1801550140 |
---|---|
Entity Type | Organization |
Authorized Contact | ABISOYE SOMORIN Ap RN 386-872-8534 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-10-22 |
Last Update Date | 2024-03-27 |