| NPI | 1104466887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARONA RACHELLE SEARCY Fnp 601-503-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |