Individual
KAYLA LOGAN CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6270
(601) 815-1828
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6270
(601) 815-1828
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0082264
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082264
FAMILY NURSE PRACTITIONER CERTIFICATION
MS
05
—
01958808
—
MS
Enumeration date
08/14/2013
Last updated
08/07/2014
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