Individual
LORI WIYGUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-3000
Mailing address
808 VARSITY DR, TUPELO, MS 38801-4613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902218
MS
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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