| NPI | 1912137720 |
|---|---|
| Doing Business As | ADVENTHEALTH MEDICAL GROUP MANCHESTER |
| Doing Business As | ADVENTHEALTH WOUND CARE AT MANCHESTER |
| Entity Type | Organization |
| Authorized Contact | SISSEL JACOB CEO 606-598-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2023-02-09 |