Individual
LISA L DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1855 LAKELAND DR, STE M20, JACKSON, MS 39216-4913
(601) 364-1132
(601) 364-1134
Mailing address
1855 LAKELAND DR, STE M20, JACKSON, MS 39216-4913
(601) 364-1132
(601) 364-1134
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R882967
MS
Other
Enumeration date
02/18/2013
Last updated
02/18/2013
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