Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1770365843 |
| LBN Legal business name | GROWING WITH YOU PEDIATRICS |
| Authorized official | TINA COAKLEY - (OWNER/PROVIDER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/13/2023 |
| Last updated | 10/25/2023 - About 3 years ago |
| Identifiers | n/a |
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