Individual
LORI MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
499 GLOSTER CREEK VLG STE D1, TUPELO, MS 38801
(662) 690-8007
Mailing address
PO BOX 305, SMITHVILLE, MS 38870-0305
(662) 651-4637
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902575
MS
Other
Enumeration date
06/25/2018
Last updated
06/26/2018
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