Individual
MINNIE FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SRNA
Contact information
Practice address
113 BRIARCLIFF DR, SALTILLO, MS 38866-6709
(662) 275-1832
Mailing address
113 BRIARCLIFF DR, SALTILLO, MS 38866-6709
(662) 275-1832
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
913163
MS
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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