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General NPI Number Information
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NPI Number | 1073018123
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Entity Type | Organization
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Legal Business Name | CG & CO AMERICAN GIRL US 7 STAR
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 48 EAST WOODLAWN AVENUE
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City | NATCHEZ
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State | MS
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Zip | 39120-4877
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Country | US
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Telephone | 601-304-2043
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Fax |
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Provider Business Mailing Address
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Address Line | 48 EAST WOODLAWN AVENUE
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City | NATCHEZ
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State | MS
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Zip | 39120-4877
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Country | US
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Telephone | 601-304-2043
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. TARSHA CARTER AMBEAU
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Credential |
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Telephone | 601-304-2043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R863813
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License Number State | MS
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