Organization · Type 2 NPI
Medical Mall Health Services of Mississippi, LLC
Primary Care Nurse Practitioner · Jackson, MS
NPI number
1194083139
Active
Practice location
350 W Woodrow Wilson Ave, Suite 499A
Jackson, MS 39213-7681
Fax (877) 852-6352
Mailing address
350 W Woodrow Wilson Ave., Suite 499A
Jackson, MS 39213-7681
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
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Other primary care nurse practitioner providers in Jackson
About NPI 1194083139
Medical Mall Health Services of Mississippi, LLC's National Provider Identifier is 1194083139, issued on Apr 27, 2012. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Jackson, MS. The record was last updated on Mar 12, 2015.