Individual
AISHA RENEA OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
400 HOSPITAL RD, STARKVILLE, MS 39759-2163
(662) 323-4320
Mailing address
103 EUDORA WELTY DRIVE, J-02, STARKVILLE, MS 39759-2163
(662) 769-9781
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R866124
MS
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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