Organization
CHRIST UNITED MEDICAL CLINIC LLC
Active
Other names
Christ United Medical Clinic, Christ United Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSA CAMERON WHITEHEAD FNP-C (FNP-C, CLINIC ADMINISTRATOR)
(662) 446-9012
Entity
Organization
Contact information
Practice address
2750 N CHURCH AVE, LOUISVILLE, MS 39339-2054
(662) 446-9012
(662) 446-9432
Mailing address
9573 HIGHWAY 490, LOUISVILLE, MS 39339-9192
(662) 446-9012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R866227
APRN LIC
MS
Enumeration date
05/28/2019
Last updated
02/11/2021
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