| NPI | 1851615710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN JACKSON Owner 520-444-8940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ RN-075070) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-06-07 |