Individual
MRS. PRINCE STENA MCCLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5578
(601) 984-4151
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5578
(601) 984-4151
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R871409
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02183861
—
MS
Enumeration date
04/22/2015
Last updated
01/05/2016
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