Individual
MS. LORRAINE GADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
127 GRANDVIEW DR, MADISON, MS 39110-7595
(601) 853-0203
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R741224
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03282005
—
MS
Enumeration date
03/27/2006
Last updated
06/14/2011
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