| NPI | 1912960980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN STOKES Office Manager 765-962-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01040082) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01047370) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71000483) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-08-22 |