Individual
BARBARA J PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
(601) 364-2600
Mailing address
3510 PEMBERTON SQUARE BLVD, VICKSBURG, MS 39180-5506
(601) 501-6991
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R586773
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115977
—
MS
Enumeration date
09/16/2006
Last updated
04/26/2019
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