is a Family in Jackson, Mississippi. practices all healthcare services and medical treatments related to Family. The NPI Number for is 1952568826. The last update date is .
's current location address is 350 W Woodrow Wilson Ave, Jackson, Mississippi. You can contact this provider via phone number 6018156869. The mailing address for is 350 W Woodrow Wilson Ave, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 350 W Woodrow Wilson Ave, Jackson, Mississippi |
Phone Number | 6018156869 |
Fax Number | |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1952568826 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 350 W Woodrow Wilson Ave |
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City | Jackson |
State | Mississippi (MS) |
Post Code | 392137681 |
Phone Number | 6018156869 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Family |
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Taxonomy | 363Lf0000X |
Licence No | R868601 |
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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6879358 | MS | -- |
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