Individual
JONNECIA WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2999 US HIGHWAY 61 N, WOODVILLE, MS 39669-7000
(601) 888-3199
Mailing address
PO BOX 39, WOODVILLE, MS 39669-0039
(601) 810-7532
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
212040
LA
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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