| NPI | 1861375651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE L WILSON Family Nurse Practitioner Owner 228-338-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-07-29 |
| Last Update Date | 2025-09-08 |