| NPI | 1942049697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE COX Ap RN, Fnp Bc, Pmhnp Bc 870-530-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-07-20 |