Green Tree Family Medical Clinic
Organization Active NPI Rural Health Clinic/Center · Mt. Olive, MS
NPI 1770741191 · NPPES record last updated Jun 2, 2008
Key facts
- NPI
- 1770741191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- GREEN TREE FAMILY MEDICAL CLINIC
- Practice address
- 603 Main Street
Mt. Olive, MS 39119 - Phone
- (601) 797-3405
- Fax
- (601) 797-4707
- NPI assigned
- Jun 2, 2008
- Organization subpart
- No
Authorized official
- Name
- Ms. Kathy M Bynum
- Title
- Clinic Director
- Phone
- (601) 765-3180
Practitioners 32
-
Twylia M. Aultman, FNP-C
-
Madelyn A Baucum, PA
-
Lacey Blakeney, NP-C
-
Nadia Shanise Clark, FNP-C
-
Melissa Coulson, NP
-
Shelby Slade Dickerson, FNP-C
-
Bria Goff, FNP-C, MPH
-
David Shane Johnson, PA-C
-
Word M Johnston, M.D.
-
Christie Kellar, FNP-C
-
Natalie Renea Keyes, FNP
-
Nicole Lott, FNP-C
-
Weaton M McDaniel, MP-C
-
Crystal Parker McNabb, FNP-C
-
Ariale Marie Nelson, FNP-C
-
Brian K Padgett, NP
-
Karen Renee Pitts, FNP
-
Katie Daley Rush, CFNP
-
Anna Seals, FNP-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
603 Main Street
Mt. Olive, MS 39119
Mailing address
PO Box 1107
Mount Olive, MS 39119-1107
Phone (601) 797-3405
Other providers in Mt. Olive, MS
- Covington County Hospital
- Dayra Floridalma Gutierrez Deleon
- Alissa Hebert-Wallace
- Integrity Therapeutic Community Services, LLC
- Joseph Eugene Johnston
- Robin L Johnston
All providers in Mt. Olive, MS · Rural Health Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.