Organization
EAST-END FAMILY MEDICAL CLINIC, LLC
Active
Organization
EAST-END FAMILY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CASSANDRA LATASHA SHEPARD FNP-BC (FNP/ADMINISTRATOR)
(662) 545-4674
Entity
Organization
Contact information
Practice address
140 NORTH ST, CLEVELAND, MS 38732-2744
(662) 545-4674
(662) 545-4715
Mailing address
1500 N BAYOU RD, CLEVELAND, MS 38732-9723
(662) 721-8036
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
01/17/2024
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