Individual
MRS. JESSICA WATSON LOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
404 S 13TH AVE, LAUREL, MS 39440-4345
(601) 425-5544
(601) 425-5525
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5800
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
903432
MS
363LA2100X
Acute Care Nurse Practitioner
Primary
903432
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09482003
—
MS
Enumeration date
09/17/2019
Last updated
06/05/2020
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