Individual
MARY E. BURES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE/DIVISION OF CARDIOLOGY, JACKSON, MS 39216-4500
(601) 984-5630
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5678
(601) 984-5638
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
R672637
MS
363L00000X
Nurse Practitioner
Primary
R672637
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114578
—
MS
05
—
106067
—
AL
01
—
P00462300
RAILROAD MEDICARE PTAN
MS
01
—
RR 00229425
RAILROAD
MS
Enumeration date
07/20/2006
Last updated
08/27/2015
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