Organization
MILESTONE PRIMARY CARE HOUSE CALLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA WALTERS FNP-C (OWNER)
(601) 540-8260
Entity
Organization
Contact information
Practice address
5260 CEDAR PARK DR STE E, JACKSON, MS 39206-4131
(601) 540-8260
Mailing address
5260 CEDAR PARK DR STE E, JACKSON, MS 39206-4131
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07935206
—
MS
Enumeration date
09/24/2019
Last updated
09/24/2019
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