NPI | 1861456287 |
---|---|
Entity Type | Organization |
Authorized Contact | MELISSA KING Director, Credentialing Enrollment 800-370-3651 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AR R32353) |
Enumeration Date | 2006-04-13 |
Last Update Date | 2017-07-11 |