Faith Family Clinic Of Booneville | |
2209 N 2nd St Booneville MS 38829-7734 | |
(662) 728-0162 | |
(662) 728-0326 |
Full Name | Faith Family Clinic Of Booneville |
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Speciality | Clinic/Center |
Location | 2209 N 2nd St, Booneville, Mississippi |
Authorized Official Name and Position | Amber Janzen (FNP) |
Authorized Official Contact | 6627280162 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Faith Family Clinic Of Booneville 2209 N 2nd St Booneville MS 38829-7734 Ph: (662) 728-0162 | Faith Family Clinic Of Booneville 2209 N 2nd St Booneville MS 38829-7734 Ph: (662) 728-0162 |
NPI Number | 1063911485 |
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Provider Enumeration Date | 02/12/2018 |
Last Update Date | 02/12/2018 |
Medicare PECOS PAC ID | 4688938715 |
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Medicare Enrollment ID | O20180426000250 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063911485 | NPI | - | NPPES |
05850217 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | R871985 (Mississippi) | Primary |
Provider Name | Brandi J Lambert |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043269236 PECOS PAC ID: 5395758171 Enrollment ID: I20060720000417 |
Provider Name | Amber L Janzen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255612081 PECOS PAC ID: 9739351230 Enrollment ID: I20111005000375 |
Provider Name | Victoria P Switcher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679107650 PECOS PAC ID: 4284063421 Enrollment ID: I20200409000053 |
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