Individual
MARLEE BOOTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1501 ASTON AVE, MCCOMB, MS 39648-2734
(601) 249-5510
(601) 249-4242
Mailing address
1592 P P WILSON RD, OSYKA, MS 39657-8162
(706) 818-1491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
284922
GA
261QX0200X
Oncology Clinic/Center
905595
MS
363LA2100X
Acute Care Nurse Practitioner
Primary
905595
MS
Other
Enumeration date
10/22/2020
Last updated
07/19/2023
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