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Individual

ESQUANICKIA C FLETCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
4635 HIGHWAY 80 E, PEARL, MS 39208-4226
(601) 933-2500
Mailing address
4635 HIGHWAY 80 E, PEARL, MS 39208-4226
(016) 933-2500

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R876414
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00936767
MS
Enumeration date
12/09/2016
Last updated
03/30/2022
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