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Organization

KUNTRY NURSE, LLC

Active
Other names
Kuntry Nurse Telehealth
Organization subpart
No

Provider details

NPI number
Authorized official
DAMETRA MANGUM FNP (CHIEF EXECUTIVE OFFICER)
(601) 310-9784
Entity
Organization

Contact information

Practice address
232 MARKET STREET, SUITE 259, FLOWOOD, MS 39232-3339
(601) 310-9784
Mailing address
1252 WEST GOVERNMENT STREET, P.O. BOX 2336, BRANDON, MS 39043-2336
(601) 310-9784

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
09/11/2023
Last updated
11/10/2024
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