Individual
STEPHANIE FARRIOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
903446
MS
363LG0600X
Gerontology Nurse Practitioner
903446
MS
Other
Enumeration date
10/23/2019
Last updated
01/19/2022
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