| NPI | 1225516354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESA COLLEEN WHITEHEAD Np C 601-395-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R853722) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2018-07-31 |