| NPI | 1578993267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEONTRANESE TREVA TAYLOR Owner 601-754-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: MS R865884) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |