| NPI | 1831506310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY NATASHA SHIMPANO Nurse Practitioner 269-470-1858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP122671) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2015-03-09 |