Individual
MS. THERESA M MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1413 W QUITMAN ST, IUKA, MS 38852-1130
(662) 424-9550
(662) 424-9558
Mailing address
1413 W QUITMAN ST, IUKA, MS 38852-1130
(662) 424-9550
(662) 424-9558
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R530581
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125347
—
MS
Enumeration date
10/04/2006
Last updated
01/21/2016
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