Individual
WHITNEY BONNER SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26 3RD ST, BELMONT, MS 38827-7737
(662) 454-4520
(662) 454-4521
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R883463
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08781307
—
MS
Enumeration date
08/16/2013
Last updated
10/15/2019
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