Individual
LISA TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
902 SGT. JOHN PITTMAN DRIVE, GREENWOOD, MS 38930-2800
(662) 207-5657
Mailing address
902 SGT. JOHN PITTMAN DRIVE, GREENWOOD, MS 38930-2800
(662) 207-5657
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R850223
MS
Other
Enumeration date
08/06/2014
Last updated
12/10/2015
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