Individual
MICHELLE VINCHWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1860 CHADWICK DR, SUITE 150A, JACKSON, MS 39204-3463
(601) 376-2818
(601) 376-2831
Mailing address
1860 CHADWICK DR, SUITE 150A, JACKSON, MS 39204-3463
(601) 376-2818
(601) 376-2831
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R860390
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01567538
—
MS
Enumeration date
01/14/2008
Last updated
09/16/2020
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