Organization
RISE AND SHINE HEALTHCARE LLC
Active
Other names
GRACE Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY GRESSETT NP (NURSE PRACTITIONER)
(601) 481-4077
Entity
Organization
Contact information
Practice address
9431 EASTSIDE DRIVE EXT STE B, NEWTON, MS 39345-8072
(601) 481-4077
Mailing address
PO BOX 70, CHUNKY, MS 39323-0070
(601) 481-4077
(620) 647-4541
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689096505
NPI NUMBER
—
Enumeration date
11/22/2021
Last updated
11/22/2021
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