Charleston Clinic
NPI #1831329887 in Charleston, Mississippi
Provider Information
- NPI Number
- 1831329887
- Entity Type
- Organization
- Organization Name
- Charleston Clinic
- Primary Specialty
- Nurse Practitioner - Community Health
- Enumeration Date
- Jul 23, 2009
- Last Updated
- Jul 6, 2011
Practice Location
- Address
- 401 S CHURCH ST
- City
- Charleston
- State
- Mississippi
- ZIP Code
- 38921-2257
- Phone
- (662) 647-5816
Authorized Official
- Name
- MRS. LISA SUDDUTH BRADHAM, FNP
- Title
- NURSE PRACTITIONER
- Phone
- (662) 647-5816
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Community Health — Community Health |
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