A R Mizell LLC
Nurse Practitioner, Family in Gulfport, MS. Organization (NPI-2).
NPI number1144582040
StatusActive
Last updated in NPPESFeb 14, 2023
Details
- NPI
- 1144582040
- Entity type
- Organization (NPI-2)
- Legal business name
- A R Mizell LLC
- Organization subpart
- No
- Enumeration date
- Jun 15, 2012
- Certification date
- Feb 14, 2023
- Last updated
- Feb 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Other names
- Southern Family Urgent Care (Doing Business As)
Practice location
1212 E Pass RdGulfport, MS 39507-3403
Phone 228-896-7108 · Fax 228-896-7174
Mailing address
Po Box 787Grand Bay, AL 36541-0787
Phone 228-896-7108 · Fax 228-896-7174
Authorized official
Amanda R Mizell
Owner
2515108175
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