| NPI | 1811748049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE BRASLAVSKY Owner 501-943-9070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2025-01-07 |