| NPI | 1093204158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FAYE THOMAS Family Nurse Practitioner 601-372-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R772161) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2019-10-29 |