Individual
LORA BETH NASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
1715 HOWARD ST UNIT B, JACKSON, MS 39202-1324
(662) 456-6101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-5019
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2023
Last updated
07/04/2023
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