| NPI | 1114364353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA TREPPENDAHL Owner/Nurse Practitioner 601-366-0855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R858785) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS r858785) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2015-07-10 |