Organization
JACKSON PUBLIC SCHOOLS LANIER CLINIC
Active
Other names
Lanier High School Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY D CROCKER R.N. (LEAD NURSE)
(601) 209-4456
Entity
Organization
Contact information
Practice address
833 MAPLE ST, JACKSON, MS 39203-3844
(601) 209-4456
(601) 960-8704
Mailing address
618 S PRESIDENT ST, JACKSON, MS 39201-5601
(601) 209-4456
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08875851
—
MS
Enumeration date
12/12/2007
Last updated
12/12/2007
Update your record
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