Individual
TEARRAH CONERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4411 39TH PL, MERIDIAN, MS 39305-3018
(601) 938-0947
Mailing address
4411 39TH PL, MERIDIAN, MS 39305-3018
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R871934
MS
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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