Individual
JENNIVIE CHRISHAE BOUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
115 HAWPOND CHURCH RD, MAGEE, MS 39111
(601) 405-2956
Mailing address
115 HAWPOND CHURCH RD, MAGEE, MS 39111
(601) 405-2956
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337263
MS
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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