Individual
JENNIFER ELAINE LACROIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RNFA
Contact information
Practice address
7148 HWY 98 WEST, SUITE 203, HATTIESBURG, MS 39402
(601) 268-5630
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5630
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
902195
MS
363L00000X
Nurse Practitioner
902195
MS
363LF0000X
Family Nurse Practitioner
Primary
902195
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08339702
—
MS
Enumeration date
05/30/2017
Last updated
11/01/2023
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