| NPI | 1144697897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA RENEE' GLOVER Family Nurse Practitioner 601-616-7653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2021-07-27 |