| NPI | 1700983913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA KAY HODGE Owner 601-799-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R767181) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 13678) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-08-18 |