| NPI | 1821469602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L STEPHENS Owner/Operator 812-291-5993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28140893A) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-11-13 |