| NPI | 1780450619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA LATASHA SHEPARD Co Owner/Family Nurse Practitioner 662-721-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2024-01-17 |