Organization
GLOVER PRIMARY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARITA GLOVERJACKSON DNP, FNP-BC (FAMILY NURSE PRACTITIONER/OWNER)
(662) 316-1334
Entity
Organization
Contact information
Practice address
403 NW DEPOT ST, DURANT, MS 39063-3705
(662) 316-1334
Mailing address
403 NW DEPOT ST, DURANT, MS 39063-3705
(662) 316-1334
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
R856333
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R856333
NURSE LICENSE
MS
Enumeration date
09/28/2013
Last updated
09/28/2013
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