| NPI | 1841811866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN BRANSCUM Business Office Manager 606-340-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-06-03 |