Individual
JESSICA CLARK MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
16569 W MAIN ST, LOUISVILLE, MS 39339-2647
(662) 773-5704
(662) 773-9463
Mailing address
PO BOX 470, LOUISVILLE, MS 39339-0470
(662) 773-5704
(662) 773-9463
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R902312
MS
363LF0000X
Family Nurse Practitioner
902312
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002487838
—
MS
Enumeration date
09/15/2017
Last updated
01/04/2023
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