Organization
DELTA PHOENIX MEDICAL CONSULTING
Active
Other names
Delta Phoenix Family and Aesthetic Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA JOY STANFORD FNP-C (OWNER SOLE PROPRIETOR)
(662) 231-8436
Entity
Organization
Contact information
Practice address
940 CHURCH RD W STE A2, SOUTHAVEN, MS 38671-9611
(662) 231-8436
(662) 536-6640
Mailing address
940 CHURCH RD W STE A2, SOUTHAVEN, MS 38671-9611
(662) 231-8436
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
11/07/2023
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