Individual
ELIZABETH MCTAGGART DIMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
255 BAPTIST BLVD STE 301, COLUMBUS, MS 39705-2006
(662) 244-2550
(662) 244-2553
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
901954
MS
Other
Enumeration date
06/22/2017
Last updated
03/17/2018
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