| NPI | 1437513108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA F POTTER Manger Fnp 662-820-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R857846) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2019-01-31 |