| NPI | 1851048037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARONDA MILLER Family Nurse Practitioner 870-703-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2023-07-19 |