Individual
MRS. EBONY HUMPHERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
Mailing address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905452
MS
Other
Enumeration date
07/20/2022
Last updated
03/13/2023
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