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Individual

JESSE JAMES PARKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(662) 244-1000
Mailing address
20010 US HIGHWAY 82, MABEN, MS 39750-9202
(662) 414-6842

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
879392
MS

Other

Enumeration date
06/10/2021
Last updated
06/10/2021
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