# STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** University Nursing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376969030
- **Authorized official:** KIM HOOVER PHD (MANAGING MEMBER)
- **Authorized official phone:** (601) 984-6220

## Contact information

- **Practice address:** 2500 N STATE ST, JACKSON, MS 39216-4500
- **Practice address phone:** (601) 984-6220
- **Mailing address:** 2500 N STATE ST, JACKSON, MS 39216-4500
- **Mailing address phone:** (601) 984-6220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/05/2014
- **Last updated:** 03/05/2014