Organization
FAMILY CARE OF EVERGREEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET EARNEST (OFFICE MANAGER)
(662) 842-4877
Entity
Organization
Contact information
Practice address
4929 HIGHWAY 371 S, NETTLETON, MS 38858-6901
(662) 963-9154
(662) 963-9157
Mailing address
PO BOX 189, PLANTERSVILLE, MS 38862-0189
(662) 963-9154
(662) 963-9157
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R713511
MS
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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