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Individual Provider (NPI-1)
Active
Registered Nurse
Provider Information
- NPI Number
1063758258- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 113 GREENFIELD WAY, MADISON, MS, 391108108
- Phone
- (601) 955-2596
Specialties & Taxonomies
Registered Nurse
Primary License: MS #r882851
Nursing Care