| NPI | 1356701783 |
|---|---|
| Former Legal Business Name | KIDS FIRST PEDIATRIC CLINIC, LLC |
| Entity Type | Organization |
| Authorized Contact | TIFFANY ROCHELLE JACKSON Family Nurse Practitioner 601-668-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: MS R881238) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2021-09-18 |