| NPI | 1881292480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE WHITLATCH CEO 606-408-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |