| NPI | 1538532221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELONIE R ROBERTS Owner 228-697-8244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS r874839) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |