| NPI | 1124392329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT NICAUD Office Manager/Administrator 228-867-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R878630) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |