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Organization

LIGHTHOUSE HEALTHCARE NANCI W PARISH NP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NANCI W PARISH NP (OWNER)
(601) 798-2005
Entity
Organization

Contact information

Practice address
6 SIEBENKITTEL CIR, SUITE E, CARRIERE, MS 39426-8777
(601) 798-2005
(601) 798-2052
Mailing address
PO BOX 419, PICAYUNE, MS 39466-0419
(601) 798-2005
(877) 635-7892

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R619442
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00117683
MS
01
01808531
GROUP MEDICAID
01
1053544155
GROUP NPI
MS
01
1245348689
INDIVIDUAL NPI
MS
Enumeration date
08/24/2009
Last updated
07/21/2014
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