Individual
JEQUETTA SHUREKA ILION MCLAURIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
713 S PEAR ORCHARD RD STE 300, RIDGELAND, MS 39157-4823
(601) 957-6300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906074
MS
Other
Enumeration date
07/27/2023
Last updated
08/02/2023
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