Individual
BRENT LEE HALLMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-3000
Mailing address
108 BURMA CV, SALTILLO, MS 38866-6992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904192
MS
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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