Individual
KERRIE SANDERS- SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4077 PEMBERTON SQUARE BLVD, VICKSBURG, MS 39180-5580
(601) 638-8600
Mailing address
140 ALFRED DR, VICKSBURG, MS 39180-9102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
875209
MS
Other
Enumeration date
12/09/2015
Last updated
11/03/2017
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