| NPI | 1821853037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE WATERFIELD Owner/Authorized Official 308-251-1913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-02-20 |