Individual
CHARLES F DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
44 BROOKLYN JANICE RD, BROOKLYN, MS 39425-9731
(601) 582-1188
Mailing address
PO BOX 357, BROOKLYN, MS 39425-0357
(601) 582-1188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903102
MS
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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