NPI | 1649051046 |
---|---|
Doing Business As | OLE BROOK KIDS WELLNESS AND URGENT CARE |
Entity Type | Organization |
Authorized Contact | AMBER NICOLE MARTIN Owner/Nurse Practitioner 601-757-9689 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
Enumeration Date | 2023-10-11 |
Last Update Date | 2023-10-11 |