Individual
SALLIE EVANS DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
1012 E MAIN ST, PHILADELPHIA, MS 39350-2308
(601) 389-7889
(601) 533-2566
Mailing address
1012 E MAIN ST STE 24, PHILADELPHIA, MS 39350-2308
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
903430
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09876307
—
MS
01
—
1841933272
NPI 2
—
Enumeration date
08/12/2019
Last updated
11/28/2023
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