Individual
TRACY B RHINEWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP BC
Contact information
Practice address
971 LAKELAND DR, SUITE 657, JACKSON, MS 39216-4643
(601) 200-2780
(601) 200-2788
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R865510
MS
364SF0001X
Family Health Clinical Nurse Specialist
Primary
R865510
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08227549
—
MS
Enumeration date
09/17/2009
Last updated
03/20/2015
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