| NPI | 1912734419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-09-18 |