NPI | 1871171496 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA PRIODE Owner/Authorized Official 606-325-6493 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
Enumeration Date | 2021-04-02 |
Last Update Date | 2024-01-11 |