| NPI | 1215396577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BERRY Owner 601-927-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS R733261) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2025-04-18 |