| NPI | 1336430594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ANN BUCKHEISTER Adult Acute Care Nurse Practitioner 228-354-9505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 6705) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MS 6705) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2020-09-04 |