Individual
MRS. AGNES PAMELA UPCHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1350 SUNSET DR, STE B, GRENADA, MS 38901-4079
(662) 229-0669
(662) 227-9929
Mailing address
1350 SUNSET DR, STE B, GRENADA, MS 38901-4079
(662) 229-0669
(662) 227-9929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R797137
MS
Other
Enumeration date
08/17/2009
Last updated
02/11/2020
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