| NPI | 1912897083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE LASHAWN RUSSELL Ap RN Msn Fnp Bc Pmhnp Bc 239-271-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-07-08 |
| Last Update Date | 2025-07-08 |