NPI | 1922671049 |
---|---|
Entity Type | Organization |
Authorized Contact | MUHAMMAD NAEEM Credentialing Manager 307-223-2266 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2021-07-19 |
Last Update Date | 2021-12-02 |