Individual
MARICYL TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
971 LAKELAND DR STE 950, JACKSON, MS 39216-4608
(601) 982-7811
Mailing address
129 SARA FOX DR, BRANDON, MS 39047-5527
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
R859763
MS
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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