| NPI | 1962800144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIAN FRACKELTON Owner/Nurse Practitioner 443-226-5597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2014-12-19 |