Individual
MARLANA PERKINS HEDGEPETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
80 HAL CROCKER RD, ELLISVILLE, MS 39437-2089
(601) 477-2221
(601) 477-2223
Mailing address
PO BOX 177, ELLISVILLE, MS 39437-0177
(601) 477-2221
(601) 477-2223
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R755324
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124941
—
MS
05
—
1783269
—
LA
01
—
640507572YV
AMERICAN ADMIN GROUP
MS
01
—
P00346938
RAILROAD MEDICARE
—
Enumeration date
09/05/2006
Last updated
12/07/2012
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