institution
Old Towne Medical Llc
Family Nurse Practitioner in Olive Branch, Mississippi
NPI 1013312172

Old Towne Medical Llc is a Family Nurse Practitioner based in Olive Branch, MS and is specialized in Family. Old Towne Medical Llc practices in Olive Branch, MS. The NPI Number for Old Towne Medical Llc is 1013312172 and holds a License No. R644986 (Mississippi).

The current practice location address for Old Towne Medical Llc is 9066 Highland St, Olive Branch, MS and can be reached out via phone at 662-890-7717 and via fax at 662-874-6038.

Location: 9066 Highland St, Olive Branch, MS, 38654-2307
institution
Provider Profile Details
NPI Number
1013312172
Provider Name
Old Towne Medical Llc
Credential
Provider Entity Type
Organization
Address
9066 Highland St, Olive Branch, MS, 38654-2307
Phone Number
662-890-7717
Fax Number
662-874-6038
Provider Enumeration Date
10/30/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
03278318 05 MS
institution
Provider Business Practice Location Address Details
Address
9066 Highland St
City
State
Zip
38654-2307
Phone Number
662-890-7717
Fax Number
662-874-6038
person
Provider Business Mailing Address Details
Address
9066 Highland St
City
State
Zip
38654-2307
Phone Number
662-890-7717
Fax Number
662-874-6038
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R644986 (Mississippi)
Definition
Definition to come...
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