Individual
MRS. FORTENISE A MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
514H E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 713-3900
(601) 713-3970
Mailing address
815 EAGLES NEST DR, BYRAM, MS 39272-9328
(601) 421-7235
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901481
MS
Other
Enumeration date
01/06/2017
Last updated
10/22/2019
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