Individual
ADRIENNE KELSEY TADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
6026 CHAPEL HILL RD, DECATUR, MS 39327-9263
(601) 692-5036
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
905076
MS
Other
Enumeration date
01/06/2022
Last updated
01/13/2022
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