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Individual

MS. CHANDRA ANITA BOSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.F.P.M.H.N.P.

Contact information

Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 815-4128
(601) 815-1828
Mailing address
PO BOX 157A, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8301

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R772275
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09528347
MS
Enumeration date
07/01/2006
Last updated
02/05/2016
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