Individual
DESTINY FUNCHESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2711 GREENWAY DR, JACKSON, MS 39204-3304
(601) 922-2876
Mailing address
2343 TIMBER XING, JACKSON, MS 39212-2350
(601) 760-2363
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100584
MS
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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