Individual
MRS. LAKENDRIA ZOLLICOFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
100 BRITTON CIR, FLOWOOD, MS 39232-8109
(601) 382-5634
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R878700
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09276202
—
MS
Enumeration date
01/16/2013
Last updated
12/05/2013
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