NPI | 1447893888 |
---|---|
Entity Type | Organization |
Authorized Contact | STACIE M PACE Owner/Director 601-466-9495 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
363LA2200X Nurse Practitioner, Adult Health | |
363LF0000X Nurse Practitioner, Family | |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2019-10-17 |
Last Update Date | 2021-04-06 |