Individual
MS. VALERIE LOGAN HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1500 E WOODROW WILSON AVE, G. V. SONNY MONTGOMERY VA, JACKSON, MS 39216-5116
(601) 362-4471
(601) 368-4089
Mailing address
2951 BIENVILLE DR, JACKSON, MS 39212-2539
(601) 346-1083
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2002017069
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002017069
FNP/ RN LICENSE NO
MO
Enumeration date
09/14/2006
Last updated
07/08/2007
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