Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1184107302 |
| LBN Legal business name | FAITH FAMILY WELLNESS CLINIC, PLLC |
| Authorized official | KRISTIN MCBAY - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/13/2018 |
| Last updated | 07/26/2022 - About 4 years ago |
| Identifiers | n/a |
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FAITH FAMILY WELLNESS CLINIC, PLLC
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