Individual
MRS. JENNIFER STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5888
(601) 261-3587
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5888
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R877154
MS
363LF0000X
Family Nurse Practitioner
Primary
877154
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02322374
—
MS
Enumeration date
02/22/2011
Last updated
08/11/2020
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