Individual
MARILYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
25 DR MARTIN LUTHER KING DR, DURANT, MS 39063-3577
(662) 739-9016
Mailing address
25 DR MARTIN LUTHER KING DR, DURANT, MS 39063-3577
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
904801
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
904801
MS
Other
Enumeration date
11/10/2021
Last updated
10/15/2025
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