| Nulife Health Care Llc | |
|
120 Holt Collier Dr Ste C Vicksburg MS 39183-4408 | |
| (601) 738-5565 | |
| (601) 738-5544 |
| Full Name | Nulife Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Holt Collier Dr Ste C, Vicksburg, Mississippi |
| Authorized Official Name and Position | Stacy Flowers (MANAGER) |
| Authorized Official Contact | 6015972362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nulife Health Care Llc 120 Holt Collier Dr Ste C Vicksburg MS 39183-4408 Ph: (601) 738-5565 | Nulife Health Care Llc 120 Holt Collier Dr Ste C Vicksburg MS 39183-4408 Ph: (601) 738-5565 |
| NPI Number | 1316616626 |
|---|---|
| Provider Enumeration Date | 09/09/2021 |
| Last Update Date | 02/25/2022 |
| Certification Date | 02/25/2022 |
| Medicare PECOS PAC ID | 6901291392 |
|---|---|
| Medicare Enrollment ID | O20220322001492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316616626 | NPI | - | NPPES |
| Provider Name | Stacy Flowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629272596 PECOS PAC ID: 0840495214 Enrollment ID: I20220322001639 |
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