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Individual

MISS MARIE JAQUELINE WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
501 MARSHALL ST, SUITE 600, JACKSON, MS 39202-1651
(601) 948-6540
(601) 326-1501
Mailing address
501 MARSHALL ST, STE 605, JACKSON, MS 39202-1650
(601) 948-6540
(601) 326-1501

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R830287
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0123514
MS
01
500017613
RAILROAD MEDICARE
MS
01
P01112718
MEDICARE RAILROAD
Enumeration date
05/31/2006
Last updated
06/29/2016
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