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General NPI Number Information
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NPI Number | 1770068637
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Entity Type | Organization
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Legal Business Name | HAPPY FEET
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 614 CHIPPEWAH DR
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City | LAUREL
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State | MS
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Zip | 39443
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Country | US
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Telephone | 601-323-7433
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Fax | 601-422-0727
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Provider Business Mailing Address
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Address Line | 614 CHIPPEWAH DR
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City | LAUREL
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State | MS
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Zip | 39443
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Country | US
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Telephone | 601-323-7433
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Fax | 601-422-0727
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MICHELE E MILLSAP
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Credential | RN, CDFS, CTBN,CTTS
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Telephone | 601-323-7433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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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 | 364SC2300X
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Taxonomy Name | Chronic Care Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #3
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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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