# EVERYCARE EXPRESS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225433436
- **Authorized official:** STEPHANIE JACKSON FNP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (601) 859-0140

## Contact information

- **Practice address:** 162 FEATHER LN, SUITE E, CANTON, MS 39046-8510
- **Practice address phone:** (601) 859-0140
- **Mailing address:** PO BOX 417, MADISON, MS 39130-0417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | R862558 | MS | Yes |

## Other

- **Enumeration date:** 10/30/2014
- **Last updated:** 12/31/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00780035 | — | MS |