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Individual

MOLLY GRUBBS MAYHUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
314 MAIN ST STE D, MONTICELLO, MS 39654-3702
(601) 587-4304
(601) 587-4515
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902712
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01071599
MS
Enumeration date
07/03/2018
Last updated
08/15/2023
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