Individual
SARA WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4400 OLD CANTON RD, JACKSON, MS 39211-5982
(601) 984-5236
Mailing address
4400 OLD CANTON RD, JACKSON, MS 39211-5982
(601) 984-5236
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903966
MS
Other
Enumeration date
06/29/2020
Last updated
06/22/2021
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