| NPI | 1396379186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA R MIZELL Owner/ Nurse Practitioner 228-896-7108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2023-02-14 |