Organization
MIZELL HEALTHCARE LLC
Active
Other names
Southern Family Urgent Care Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BABETTE JACKSON (ADMINISTRATOR)
(251) 802-3595
Entity
Organization
Contact information
Practice address
1962 SPRING HILL AVE, MOBILE, AL 36607-2304
(251) 802-3595
Mailing address
PO BOX 787, GRAND BAY, AL 36541-0787
(251) 802-3595
(228) 896-7174
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293842
—
AL
Enumeration date
10/11/2022
Last updated
02/14/2023
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