Organization
STAR HEALTHCARE REGISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIA SIMS (OWNER/DIRECTOR)
(601) 918-4669
Entity
Organization
Contact information
Practice address
113 MAXWELL CV, TERRY, MS 39170-9514
(601) 918-4669
Mailing address
PO BOX 13993, JACKSON, MS 39236-3993
(601) 918-4669
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P320903
MS
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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