| NPI | 1871117580 |
|---|---|
| Former Legal Business Name | SUSAN BRANHAM |
| Entity Type | Organization |
| Authorized Contact | SUSAN BRANHAM Nurse Practitioner 903-575-7856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |