| Heal All Wound Care Llc | |
|
660 Lakeland East Dr Ste 210 Flowood MS 39232-9777 | |
| (601) 665-4162 | |
| (855) 830-3484 |
| Full Name | Heal All Wound Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 660 Lakeland East Dr Ste 210, Flowood, Mississippi |
| Authorized Official Name and Position | John C Duke (COO) |
| Authorized Official Contact | 0166654162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heal All Wound Care Llc 215 Katherine Dr Ste A Flowood MS 39232-9588 Ph: (601) 665-4162 | Heal All Wound Care Llc 660 Lakeland East Dr Ste 210 Flowood MS 39232-9777 Ph: (601) 665-4162 |
| NPI Number | 1093554982 |
|---|---|
| Provider Enumeration Date | 05/21/2024 |
| Last Update Date | 12/23/2024 |
| Medicare PECOS PAC ID | 8123561966 |
|---|---|
| Medicare Enrollment ID | O20240620002989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093554982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Cassandra Amos Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356856561 PECOS PAC ID: 0446513642 Enrollment ID: I20180423002197 |
| Provider Name | Sonya Whatley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841756731 PECOS PAC ID: 7214270131 Enrollment ID: I20190516001935 |
| Provider Name | Roxane T Moncure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396202396 PECOS PAC ID: 8224949433 Enrollment ID: I20191018000052 |
| Provider Name | Lameka Q Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720631161 PECOS PAC ID: 2668750472 Enrollment ID: I20200506000843 |
| Provider Name | Kayla B Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114545464 PECOS PAC ID: 5597189399 Enrollment ID: I20200727002945 |
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