Individual
MRS. SARA MARIE PRESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NNP-BC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100
Mailing address
109 MEMORY LN, MADISON, MS 39110-6866
(601) 918-2771
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
R882659
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00970578
—
MS
Enumeration date
08/06/2013
Last updated
01/09/2014
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