Provider Demographics
NPI:1770068637
Name:HAPPY FEET
Entity type:Organization
Organization Name:HAPPY FEET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLSAP
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CDFS, CTBN,CTTS
Authorized Official - Phone:601-323-7433
Mailing Address - Street 1:614 CHIPPEWAH DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39443
Mailing Address - Country:US
Mailing Address - Phone:601-323-7433
Mailing Address - Fax:601-422-0727
Practice Address - Street 1:614 CHIPPEWAH DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39443
Practice Address - Country:US
Practice Address - Phone:601-323-7433
Practice Address - Fax:601-422-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic CareGroup - Multi-Specialty