| NPI | 1982306502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI MICHELLE HUBERT Owner 361-720-9930 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-03-20 |