Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Community Health |
261QC1500X | |||
Family |
363LF0000X | 50 | Nurse Practitioner | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Physician Assistant |
363A00000X | 97 | Physician Assistant | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Research |
261QR1100X |
| NPI Number | 1477743755 |
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| LBN Legal business name | EDGAR NOLLNER HEALTH CENTER | ||||
| Authorized official | KIM WOLF - (FINANCE MANAGER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 08/01/2007 | ||||
| Last updated | 11/10/2008 - About 18 years ago | ||||
| Identifiers |
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