Individual
LYDIA MICHELLE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2500 N. STATE STREET, JACKSON, MS 39216-4505
(601) 984-1000
Mailing address
2500 N. STATE STREET, JACKSON, MS 39216-4505
(601) 815-6960
(601) 815-9760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-124631
MT
Other
Enumeration date
08/18/2014
Last updated
08/10/2023
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