| NPI | 1992442156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY LAYMAN Sr VP Corporate Medical Director 866-434-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2026-05-21 |