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Individual

DR. JASMINE KINATA MINNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, ACNPC- AG

Contact information

Practice address
9141 MALLARD PARK BLVD, WALLS, MS 38680-8003
(901) 907-7676
Mailing address
9141 MALLARD PARK BLVD, WALLS, MS 38680-8003
(901) 907-7676

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
29597
TN
363LA2100X
Acute Care Nurse Practitioner
904928
MS

Other

Enumeration date
09/07/2021
Last updated
02/16/2022
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