| NPI | 1679600522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY G HAYHURST Owner 662-286-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R560634) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |