Organization
FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LADONNA MICHELLE BRANCH FNP (CERTIFIED NURSE PRACTIONER)
(601) 425-3033
Entity
Organization
Contact information
Practice address
117 S 11TH AVE, LAUREL, MS 39440-4312
(601) 425-3033
(601) 428-6561
Mailing address
117 S 11TH AVE, LAUREL, MS 39440-4312
(601) 425-3033
(601) 428-6561
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
R872330
MS
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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