| NPI | 1942332598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANNE HANSEN Owner 940-224-9274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 570268) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-08-16 |