| NPI | 1811246390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE ANN ALLEN Credentialing Coordinator 904-296-5690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 214209) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NC 214209) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-08-30 |