| NPI | 1821962440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHATINA MARTIN Nurse Practitioner/Provider 601-622-5620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-10-06 |
| Last Update Date | 2025-10-06 |