Individual
JACOB WARREN SPRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
414 HARDY LN, BROOKHAVEN, MS 39601-4046
(601) 320-6886
Mailing address
414 HARDY LN, BROOKHAVEN, MS 39601-4046
(601) 320-6886
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
893703
MS
363LF0000X
Family Nurse Practitioner
Primary
904385
MS
390200000X
Student in an Organized Health Care Education/Training Program
893703
MS
Other
Enumeration date
09/09/2020
Last updated
02/15/2021
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