| NPI | 1740412287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CULLEN Fnp 662-238-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R857620) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2021-03-15 |