| NPI | 1982095543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODIE SLAYER Analyst, Physician Credentialing 629-224-1621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95001923) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2025-11-14 |