Individual
WENDY L BALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APMHNP
Contact information
Practice address
557 GRANTS FERRY RD, BRANDON, MS 39047-9023
(601) 665-4162
Mailing address
PO BOX 6537, LAUREL, MS 39441-6537
(601) 426-9614
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R854865
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01934596
—
MS
Enumeration date
11/03/2011
Last updated
02/08/2022
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