| NPI | 1811683618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LEE Owner 515-570-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2024-01-14 |