Individual
TERESA CONERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Contact information
Practice address
430 W BROAD ST, MONTICELLO, MS 39654-7723
(601) 825-7280
(601) 825-8130
Mailing address
12 MCCRAY RD, JAYESS, MS 39641-8053
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855066
MS
Other
Enumeration date
12/02/2013
Last updated
10/14/2016
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