| NPI | 1932947165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WIGFALL CEO 980-278-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |