Individual
MRS. TANYONISHA ROKAYE DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 SHARON HILLS DR, JACKSON, MS 39212-2234
(601) 918-6275
Mailing address
411 SHARON HILLS DR, JACKSON, MS 39212-2234
(601) 918-6275
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R856193
MS
163WC0200X
Critical Care Medicine Registered Nurse
R856193
MS
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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