Organization
360 HEALTHCARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENETTA D PARKER NP-C (OWNER)
(769) 572-7819
Entity
Organization
Contact information
Practice address
202 SAINT PAUL ST, PEARL, MS 39208-5134
(769) 572-7819
Mailing address
202 SAINT PAUL ST, PEARL, MS 39208-5134
(769) 572-7819
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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