| NPI | 1972321842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUCCI Owner 855-743-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |