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Individual

EDITH WHEATLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3814 FARM POND CV E, SOUTHAVEN, MS 38671-7073
(901) 299-7736
Mailing address
3814 FARM POND CV E, SOUTHAVEN, MS 38671-7073
(901) 299-7736

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A019170
MS

Other

Enumeration date
02/20/2017
Last updated
02/20/2017
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