| NPI | 1972376234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANEE MOORE Fnp Bc 205-378-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2024-03-26 |