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General NPI Number Information
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NPI Number | 1285256271
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Entity Type | Organization
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Legal Business Name | AMARIS MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 308 N JACKSON ST
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3322
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Country | US
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Telephone | 662-582-1925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 372
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City | KOSCIUSKO
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State | MS
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Zip | 39090-0372
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Country | US
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Telephone | 662-582-1925
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. ANITA GREER
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Credential | NP
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Telephone | 662-582-1925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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