Organization
EXCELLENCE CONCIERGE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRANDA D WHITE FNP (FNP/CEO)
(901) 832-6805
Entity
Organization
Contact information
Practice address
7712 KERI CV, OLIVE BRANCH, MS 38654-5049
(901) 832-6805
Mailing address
6515 GOODMAN RD, SUITE 4 BOX 298, OLIVE BRANCH, MS 38654
(901) 832-6805
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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