Organization
CHILDREN'S ACCELERATION PROGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS MITCHELL NP (DIRECTOR)
(662) 627-2741
Entity
Organization
Contact information
Practice address
112 ISSAQUENA AVE, CLARKSDALE, MS 38614-4315
(662) 627-2741
Mailing address
PO BOX 1382, CLEVELAND, MS 38732-1382
(662) 627-2741
(662) 846-6306
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R125740
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00009266
—
MS
05
—
00020541
—
MS
Enumeration date
01/11/2007
Last updated
08/22/2020
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