| NPI | 1528465424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATIVEL COLLINS Np/Owner 662-842-7840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R873068) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2015-01-27 |