| NPI | 1871930909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN M KERNAN Family Nurse Practitioner 458-210-2940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 201150172NP) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2018-04-18 |