| NPI | 1881472488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEWEL WALTERS Ap RN 475-238-0639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2024-01-19 |