| NPI | 1124494109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L GRUBBS Certified Nurse Practitioner 601-705-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R860597) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |