Individual
LAURA K TANKSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1040 GLUCKSTADT RD STE B, GLUCKSTADT, MS 39110-7228
(601) 605-0452
Mailing address
1040 GLUCKSTADT RD STE B, GLUCKSTADT, MS 39110-7228
(601) 605-0452
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
906373
MS
Other
Enumeration date
01/30/2024
Last updated
02/26/2026
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