Individual provider · Type 1 NPI

Justine Eve Maril Buslon Ibale

Student in an Organized Health Care Education/Training Program · Jackson, MS

NPI number 1700405206 Active

Practice location

2500 N State St
Jackson, MS 39216-4500

Call (601) 984-6562 Map

Fax (601) 918-2086

Mailing address

300 Kirkwood Dr
Clinton, MS 39056-5882

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1700405206

Justine Eve Maril Buslon Ibale's National Provider Identifier is 1700405206, issued on Apr 14, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jackson, MS. The record was last updated on Apr 14, 2020.