NPI | 1407114432 |
---|---|
Doing Business As | EMMANUEL MEDICAL CLINIC |
Entity Type | Organization |
Authorized Contact | DONNA KAY PITTMAN CEO 601-209-5133 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R845316) |
Enumeration Date | 2012-04-27 |
Last Update Date | 2019-07-09 |