INNOVATIVE HEALTH LLC NPI 1174755359

NPI Information

INNOVATIVE HEALTH LLC is an obstetrics and gynecology nurse practitioner in Jackson, MS. INNOVATIVE HEALTH LLC NPI is 1174755359. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

501 MARSHALL ST STE 605
JACKSON, MS
ZIP 39202-650
Phone: (601) 968-1690
Fax: (601) 968-1693

The provider's authorized official is Marie J Williams .
The authorized official title is Owner/ceo and has the following contact phone number (601) 968-1690.

The CLIA number assigned to this NPI record is 25D2040313 - other - nurse practitioner with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/20/2009 and was last updated on 1/17/2020.

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:

Other Identifiers

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