Organization
MIDNIGHT-MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALYSSA R MANNING (CREDENTIALING)
(662) 266-2393
Entity
Organization
Contact information
Practice address
848 S MADISON ST, TUPELO, MS 38801-4905
(662) 844-4177
(662) 844-3077
Mailing address
848 S MADISON ST, TUPELO, MS 38801-4905
(662) 844-4177
(662) 844-3077
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06937811
—
MS
Enumeration date
04/28/2009
Last updated
11/13/2019
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