Individual
LADONNA BAKER DELARIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3949 MS-43, BRANDON, MS 39047
(855) 712-7627
Mailing address
160 INGLESIDE RD, MADISON, MS 39110-9729
(601) 383-0877
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905557
MS
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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