Individual
NETTIE HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1006 TREETOPS BLVD STE 105, FLOWOOD, MS 39232-7645
(601) 519-4466
(601) 374-5737
Mailing address
1006 TREETOPS BLVD STE 105, FLOWOOD, MS 39232-7645
(601) 519-4466
(601) 374-5737
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
956
MS
152WC0802X
Corneal and Contact Management Optometrist
956
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08753003
—
MS
01
—
956
OPTOMETRY STATE LICENSE
MS
Enumeration date
07/27/2017
Last updated
10/28/2020
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