| NPI | 1992561500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOIE LYNN TEDDER Ap RN,Fnp C/Provider/Owner 620-660-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-10-29 |