ELITE HEALTH CLINIC LLC NPI 1538752084

NPI Information

ELITE HEALTH CLINIC, LLC is a women's health clinical nurse specialist in Gulfport, MS. ELITE HEALTH CLINIC, LLC NPI is 1538752084. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

428 COURTHOUSE RD STE B
GULFPORT, MS
ZIP 39507-868
Phone: (228) 207-0408
Fax: (228) 207-0409

The provider's authorized official is Crystal D. Heathington .
The authorized official title is Np/owner and has the following contact phone number (228) 207-0408.

The CLIA number assigned to this NPI record is 25D1012611 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/16/2021 and was last updated on 2/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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