Organization
FAITH FAMILY CLINIC OF BOONEVILLE
Active
Organization
FAITH FAMILY CLINIC OF BOONEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMBER JANZEN FNP (FNP)
(662) 728-0162
Entity
Organization
Contact information
Practice address
2209 N 2ND ST, BOONEVILLE, MS 38829-7734
(662) 728-0162
(662) 728-0326
Mailing address
2209 N 2ND ST, BOONEVILLE, MS 38829-7734
(662) 728-0162
(662) 728-0326
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
R871985
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05850217
—
MS
Enumeration date
02/12/2018
Last updated
02/12/2018
Update your record
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