| NPI | 1962085084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRADFORD Officer/CFO 270-762-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| 367A00000X Advanced Practice Midwife | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-09-10 |