Individual
MS. LEA ANN BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1024 MARTIN LUTHER KING DR, MARKS, MS 38646-1832
(662) 326-3500
Mailing address
PO BOX 289, MARKS, MS 38646-0289
(662) 326-3500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R823849
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06678813
—
MS
Enumeration date
10/22/2012
Last updated
06/10/2015
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