Charles Ray Strange III
Nurse Practitioner, Family in Wiggins, MS. Individual provider (NPI-1).
NPI number1164086716
StatusActive
Last updated in NPPESApr 30, 2019
Details
- NPI
- 1164086716
- Entity type
- Individual (NPI-1)
- Name
- Charles Ray Strange III
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 30, 2019
- Last updated
- Apr 30, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 903317 | MS | Yes |
Practice location
1130 Frontage Dr WWiggins, MS 39577-8165
Phone 601-716-8012 · Fax 601-716-8013
Mailing address
Po Box 1258Waynesboro, TN 38485-1258
Phone 931-253-1110 · Fax 256-664-4280
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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