Provider Demographics
NPI:1437882800
Name:NUCARE MEDICAL AND WEIGHT LOSS CENTER
Entity Type:Organization
Organization Name:NUCARE MEDICAL AND WEIGHT LOSS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAR'CISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:228-218-9588
Mailing Address - Street 1:PO BOX 7629
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-7601
Mailing Address - Country:US
Mailing Address - Phone:601-283-8999
Mailing Address - Fax:
Practice Address - Street 1:249 BEAUVOIR RD STE C1-3
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4008
Practice Address - Country:US
Practice Address - Phone:601-283-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty