Divinity Pediatric Clinic, Pllc
NPI #1629741152 in Pearl, Mississippi
Provider Information
- NPI Number
- 1629741152
- Entity Type
- Organization
- Organization Name
- Divinity Pediatric Clinic, Pllc
- Primary Specialty
- Nurse Practitioner - Pediatrics
- Enumeration Date
- Jul 29, 2021
- Last Updated
- Sep 3, 2022
Practice Location
- Address
- 200 RIVERWIND DR STE 104
- City
- Pearl
- State
- Mississippi
- ZIP Code
- 39208-5652
- Phone
- (601) 345-4044
Authorized Official
- Name
- REKITA D. MCCOY, FNP
- Title
- CEO
- Phone
- (601) 345-4044
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
| Nurse Practitioner - Pediatrics — Pediatrics |
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