Organization · Type 2 NPI
Supreme Wisdom Family Health Clinic Inc
Family Nurse Practitioner · Grand Prairie, TX
NPI number
1801176474
Active
Practice location
455 Gotland Dr
Grand Prairie, TX 75052-2570
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 682811 (TX) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1801176474
Supreme Wisdom Family Health Clinic Inc's National Provider Identifier is 1801176474, issued on Aug 26, 2011. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Grand Prairie, TX. The record was last updated on Sep 15, 2011.