| NPI | 1811862113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEDELLE LUREE HENDERSON-BAMIDELE Np 302-276-9590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 133V00000X Dietitian, Registered | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2026-05-01 |