| NPI | 1922136852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM A. NELSON VP Of Finance 866-904-7721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| 261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2017-05-11 |