| NPI | 1952877581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJA BOX BEATY VP Operations 800-793-7050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2023-04-27 |