| NPI | 1891814802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS STACKER CEO 662-378-3783 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-11-14 |