| NPI | 1659527414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY DARLENE CROCKER Lead Nurse 601-209-4456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health |
| Additional Taxonomies | 163WS0200X Registered Nurse School (Licence: MS R557579) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |