| NPI | 1699526947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE SHERICE TAYLOR Doctor Of Nursing Practice 662-523-7016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2025-02-22 |