Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1437973427 |
| LBN Legal business name | ABUNDANT HARVEST HEALTH AND HEALING, LLC |
| Authorized official | BONITA CLARK - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/14/2024 |
| Last updated | 11/14/2024 - More than a year ago |
| Identifiers | n/a |
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