NPI | 1093499907 |
---|---|
Doing Business As | MISSISSIPPI MEDICAL CLINIC MENDENHALL |
Entity Type | Organization |
Authorized Contact | CHANTE N FERGUSON Owner 601-675-1200 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Enumeration Date | 2023-06-12 |
Last Update Date | 2024-02-16 |