| NPI | 1871399212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUELA C CONSEILLANT Provider 229-234-9695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |