Individual
MIA ROBERNETTE TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1 CVS DR, WOONSOCKET, RI 02895-6195
(401) 581-6303
Mailing address
14601 CONSTITUTION RD, MOSS POINT, MS 39562-6375
(228) 712-0396
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
864476
MS
Other
Enumeration date
09/14/2019
Last updated
01/22/2025
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