| NPI | 1891233276 |
|---|---|
| Former Legal Business Name | OPTIMUM HEALTHCARE ASSOCIATES, LLC |
| Entity Type | Organization |
| Authorized Contact | FELISA DENISE WILSON-SIMPSON Owner/CEO/Np 601-397-6236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R784445) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS R784445) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-11-22 |