Individual
AMY LOWERY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-AC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2000
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
R864240
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05130237
—
MS
05
—
2365746
—
LA
Enumeration date
07/26/2013
Last updated
06/20/2014
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