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Individual

KAREN CHRISTINE ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
102 WEST FREEDOM DRIVE, LIBERTY, MS 39645
(601) 657-8091
Mailing address
P O BOX 511, LIBERTY, MS 39645
(601) 657-4326

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R871215
MS
363LF0000X
Family Nurse Practitioner
RN107115
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09010048
MS
Enumeration date
06/14/2012
Last updated
12/12/2012
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