Provider Demographics
NPI:1508267295
Name:NATCHEZ AFTER HOURS CLINIC, PLLC
Entity Type:Organization
Organization Name:NATCHEZ AFTER HOURS CLINIC, PLLC
Other - Org Name:NATCHEZ URGENT CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SERIO
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:601-442-1900
Mailing Address - Street 1:105 NORTHGATE RD STE D
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-9162
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 NORTHGATE RD STE D
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-9162
Practice Address - Country:US
Practice Address - Phone:601-442-1900
Practice Address - Fax:601-442-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty