NPI | 1881212348 |
---|---|
Entity Type | Organization |
Authorized Contact | JEREMY WAYNE CREEKMORE Owner 808-398-0537 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2020-07-10 |
Last Update Date | 2025-09-02 |