Individual
CANDICE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213
(601) 362-5321
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
902442
MS
Other
Enumeration date
08/22/2014
Last updated
07/04/2018
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