Organization Name: | FAMILY CLINIC FOR HEALTH & WELLNESS, LLC. |
NPI Number: | 1124275581 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YOLANDA CAPRICE CHANDLER (OWNER) |
Mailing Address: | 55 Sergeant Prentiss Dr Suite 104 Natchez |
State: | MS US |
Postal Code: | 391204782 |
Phone Number: | 6014455556 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2008 |
NPI Last Update Date: | 11/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R850771 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |