| NPI | 1639597966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY K MCDANIEL President 601-636-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS R829001) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-06-19 |