Organization
COMMUNITY FAMILY HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOY LODEN CFNP (OWNER)
(662) 282-4197
Entity
Organization
Contact information
Practice address
285 IVIE LANE, MANTACHIE, MS 38855
(662) 282-4197
Mailing address
285 IVIE LANE, MANTACHIE, MS 38855
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R857240
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02324272
—
MS
05
—
09016148
—
MS
01
—
1720180979
NPI INDIVIDUAL #
MS
Enumeration date
05/03/2007
Last updated
08/22/2020
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