Organization
HEALTHY ME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LERESHA GERARD (CEO/ADMINISTRATOR)
(662) 226-4010
Entity
Organization
Contact information
Practice address
104 DAVIS ST, COFFEEVILLE, MS 38922-9273
(662) 614-3031
Mailing address
PO BOX 186, GRENADA, MS 38902-0186
(662) 226-4010
(662) 226-4495
Taxonomy
Speciality
Code
Description
License number
State
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
—
MS
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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