Individual
JEANNIE D PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CANP
Contact information
Practice address
1542 MEDICAL PARK CIR, TUPELO, MS 38801-6560
(662) 844-4711
(662) 844-9619
Mailing address
1542 MEDICAL PARK CIR, TUPELO, MS 38801-6560
(662) 844-4711
(662) 844-9619
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R682519
MS
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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