Individual
MRS. LISA MICHELLE GANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1521 A 22ND AVENUE, MERIDIAN, MS 39301
(601) 703-8360
(601) 703-8369
Mailing address
1710 14TH ST, MERIDIAN, MS 39301-4140
(601) 703-1485
(601) 703-1488
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R827388
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03505015
—
MS
Enumeration date
08/17/2009
Last updated
09/10/2024
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