Organization
US STAR NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARSHA CARTER AMBEAU (MANAGER)
(601) 304-2043
Entity
Organization
Contact information
Practice address
48 EAST WOODLAWN AVENUE, NATCHEZ, MS 39120
(601) 304-2043
Mailing address
48 EAST WOODLAWN AVENUE, NATCHEZ, MS 39120
(601) 304-2043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04821760
—
MS
Enumeration date
02/16/2019
Last updated
02/16/2019
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