| Doctor Name: | MRS. ELIZABETH P BRAGG |
| NPI Number: | 1629371653 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNPC |
| License Number: | R866848 |
| Business Practice Address: | 3550 Highway 468 West Whitfield, MS - 391930157 |
| Business Phone Number: | 6013518000 |
| Business Fax Number: | 6013518586 |
| Mailing Address: | P.o. Box 1, 3550 Highway 468 West WHITFIELD |
| State: | MS |
| Postal Code: | 391930157 |
| Phone Number: | 6013518000 |
| Fax Number: | 6013518586 |
| NPI Enumeration Date: | 12/14/2010 |
| NPI Last Update Date: | 12/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R866848 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |