Provider Demographics
NPI:1386949501
Name:HEALTH CARE PLUS
Entity type:Organization
Organization Name:HEALTH CARE PLUS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONJA
Authorized Official - Middle Name:G
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:662-720-7970
Mailing Address - Street 1:305 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-2029
Mailing Address - Country:US
Mailing Address - Phone:662-720-7970
Mailing Address - Fax:662-720-7967
Practice Address - Street 1:305 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-2029
Practice Address - Country:US
Practice Address - Phone:662-720-7970
Practice Address - Fax:662-720-7967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850478364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty