Caledonia Community Clinic

LBN: Fig Leaf, Llc
Caledonia Community Clinic is an health care organization with primary practice located at 171 South St , Caledonia MS 39740. The organization recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is the primary health care specialty. Fig Leaf, Llc can be contacted via phone (662) 251-7389, or through Fondren, Amanda via phone (662) 855-0080.

Contact Information

Primary practice address
171 South St Caledonia MS 39740
Phone: (662) 251-7389
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fondren, Amanda FNP-C
Phone: (662) 855-0080

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R858548 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1013426329
LBN Legal business name Fig Leaf, Llc
DBA Doing business as Caledonia Community Clinic
Authorized official Fondren, Amanda FNP-C
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2017
Last updated May 22nd, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013426329 NPPES
Other 1851792626 NPI

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