NPI | 1972136919 |
---|---|
Other Name | BURGEONING HEALTH PROVIDERS, LLC |
Entity Type | Organization |
Authorized Contact | MALINDA BUTLER Manager 317-659-5905 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2020-02-18 |
Last Update Date | 2021-09-11 |