| NPI | 1861770984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHILOH A STOCKSDALE Owner 812-590-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002199A) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-08-25 |