Organization
PREMIER FAMILY AND URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HICKS-ROBERTSON FNP (OWNER)
(662) 840-4577
Entity
Organization
Contact information
Practice address
2394 MCCULLOUGH BLVD, BELDEN, MS 38826-9579
(622) 053-0236
(844) 465-9102
Mailing address
2394 MCCULLOUGH BLVD, BELDEN, MS 38826-9579
(662) 269-1774
(844) 465-9102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03403770
—
MS
Enumeration date
02/25/2019
Last updated
08/31/2020
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