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Aa Primary Care Services, LLC

Nurse Practitioner, Family in Hattiesburg, MS. Organization (NPI-2).

NPI number1962762401
StatusActive
Last updated in NPPESSep 8, 2015

Details

NPI
1962762401
Entity type
Organization (NPI-2)
Legal business name
Aa Primary Care Services, LLC
Organization subpart
No
Enumeration date
May 17, 2012
Last updated
Sep 8, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyR852821MSYes

Practice location

134 Jervis Mims Rd
Hattiesburg, MS 39401-8864

Phone 601-255-5705

Mailing address

134 Jervis Mims Rd
Hattiesburg, MS 39401-8864

Authorized official

Lisa Parker
Owner
6015546959

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