Organization
JACKSONBRACEY HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN LILES (OFFICE STAFF)
(601) 937-5415
Entity
Organization
Contact information
Practice address
4490 US-80, PEARL, MS 39208
(601) 383-1977
Mailing address
4490 HIGHWAY 80 E, PEARL, MS 39208-4213
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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