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General NPI Number Information
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NPI Number | 1538863725
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Entity Type | Organization
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Legal Business Name | MANNA MINISTRIES
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 120 STREET A
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City | PICAYUNE
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State | MS
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Zip | 39466-5466
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Country | US
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Telephone | 769-242-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 2416 HIGHWAY 43 S STE B
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City | PICAYUNE
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State | MS
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Zip | 39466-7462
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | APRIL ARNONA
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Credential |
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Telephone | 769-242-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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