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Evergreen Clini
Family Nurse Practitioner in Nettleton, Mississippi
NPI 1396763298

Evergreen Clini is a Family Nurse Practitioner based in Nettleton, MS and is specialized in Family. Evergreen Clini practices in Nettleton, MS. The NPI Number for Evergreen Clini is 1396763298 and holds a License No. (Mississippi).

The current practice location address for Evergreen Clini is 4929 Highway 371 S, Nettleton, MS and can be reached out via phone at 662-963-9154 and via fax at 662-963-9157.

Location: 4929 Highway 371 S, Nettleton, MS, 38858-6901
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1396763298
Provider Name
Evergreen Clini
Credential
Provider Entity Type
Organization
Address
4929 Highway 371 S, Nettleton, MS, 38858-6901
Phone Number
662-963-9154
Fax Number
662-963-9157
Provider Enumeration Date
07/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
09013494 05 MS
institution
Provider Business Practice Location Address Details
Address
4929 Highway 371 S
City
Nettleton
State
Mississippi
Zip
38858-6901
Phone Number
662-963-9154
Fax Number
662-963-9157
person
Provider Business Mailing Address Details
Address
4929 Highway 371 S
City
Nettleton
State
Mississippi
Zip
38858-6901
Phone Number
662-963-9154
Fax Number
662-963-9157
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
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Definition
Definition to come...
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