Individual
CATHY LEE HEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3440 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 638-0031
Mailing address
3440 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 638-0031
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
341095
MS
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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