A Healthy You Medical Clinic, "l.L.C."
Nurse Practitioner in Clarksdale, MS. Organization (NPI-2).
NPI number1982140448
StatusActive
Last updated in NPPESMay 20, 2019
Details
- NPI
- 1982140448
- Entity type
- Organization (NPI-2)
- Legal business name
- A Healthy You Medical Clinic, "l.L.C."
- Organization subpart
- No
- Enumeration date
- Jan 9, 2017
- Last updated
- May 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
1202 Desoto AveSuite A
Clarksdale, MS 38614-6937
Phone 662-209-1202 · Fax 662-483-1627
Mailing address
1202 Desoto AveSuite A
Clarksdale, MS 38614-6937
Phone 662-209-1202 · Fax 662-483-1627
Authorized official
Lula Owens Hoskins
Provider
6622091202
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