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Organization

NORTH LAUREL FAMILY MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. HOPE JACKSON (BILLING/CREDENTIALING)
(601) 498-4673
Entity
Organization

Contact information

Practice address
3115 AUDUBON DR, LAUREL, MS 39440
(601) 531-2200
(601) 531-2220
Mailing address
3115 AUDUBON DR, LAUREL, MS 39440-1913
(601) 531-2200
(601) 531-2220

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08886271
MS
Enumeration date
05/08/2018
Last updated
01/16/2025
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