| NPI | 1336706803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY PHILLIPS CEO 662-635-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |