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Individual

AMANDA CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
PO BOX 2504, RIDGELAND, MS 39158-2504
(769) 798-5008

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
891948
MS
363LF0000X
Family Nurse Practitioner
Primary
904355
MS

Other

Enumeration date
01/05/2021
Last updated
02/03/2021
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