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Individual

KARA M AVERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2115 STABLE LN, JACKSON, MS 39212-2582
(769) 218-6885
Mailing address
10 CANEBRAKE BLVD, FLOWOOD, MS 39232-2211
(769) 218-6885

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85-2380684
MS
Enumeration date
01/19/2021
Last updated
01/19/2021
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