NPI | 1912960980 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICIA ANN STOKES Office Manager 765-962-0414 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71000483) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01040082) |
207R00000X Internal Medicine (Licence: IN 01047370) | |
Enumeration Date | 2006-04-10 |
Last Update Date | 2025-09-11 |