Organization Name: | COURT SQUARE RURAL HEALTH CLINIC |
NPI Number: | 1306966502 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIMLLBERLY FLETCHER SIMS (PARTNER) |
Mailing Address: | 406 East Court St. Sumner |
State: | MS US |
Postal Code: | 38957 |
Phone Number: | 6623757717 |
Fax Number: | 6623757719 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 08/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |