| NPI | 1487437786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL NWAGWU Owner 601-209-2094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 171M00000X Case Manager/Care Coordinator | |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 251B00000X Case Management | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-09-10 |