| NPI | 1346057585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ROULIER Nurse Practitioner 601-480-3986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |