Evergreen Clini is a Family in Nettleton, Mississippi. Evergreen Clini practices all healthcare services and medical treatments related to Family. The NPI Number for Evergreen Clini is 1396763298. The last update date is 2020-08-22.
Evergreen Clini's current location address is 4929 Highway 371 S, Nettleton, Mississippi. You can contact this provider via phone number 6629639154 and fax number 6629639157. The mailing address for Evergreen Clini is 4929 Highway 371 S, Nettleton, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Evergreen Clini |
|---|---|
| Address | 4929 Highway 371 S, Nettleton, Mississippi |
| Phone Number | 6629639154 |
| Fax Number | 6629639157 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Stevens Jerry |
| Telephone Number | 6629639154 |
NPI Number Detail
| NPI Number | 1396763298 |
|---|---|
| Provider Enumeration Date | 2006-07-18 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4929 Highway 371 S |
|---|---|
| City | Nettleton |
| State | Mississippi (MS) |
| Post Code | 388586901 |
| Phone Number | 6629639154 |
| Fax Number | 6629639157 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9013494 | MS | -- |
Post Comment/ Review Below
What is the Evergreen Clini's 1396763298?
The Evergreen Clini's NPI (National Provider Identifier) Number is 1396763298. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Evergreen Clini's physical address?
The Evergreen Clini is physically located at 4929 Highway 371 S, in the city of Nettleton, MS, with the postal code 388586901.
What is the area of specialization for Evergreen Clini, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Evergreen Clini is Family, and the corresponding taxonomy code that categorizes this area of expertise is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1396763298 to Evergreen Clini?
The Centers for Medicare & Medicaid Services originally issued the 1396763298 to Evergreen Clini on 2006-07-18.
As of what date were the Evergreen Clini's details last updated?
The information pertaining to the Evergreen Clini, including its address, specialty, and other details, was most recently updated on 2020-08-22.
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