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Individual

PRISCILLA ELIZABETH PULLIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1030 RIVER OAKS DR, JACKSON, MS 39232-9553
(601) 924-3719
Mailing address
2500 NORTH STATE STREET, JMM ROOM 2525, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-6439

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
865613
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07338051
MS
Enumeration date
05/05/2006
Last updated
05/23/2023
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