Individual
BONNIE DURRETT SISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAS
Contact information
Practice address
165 W SOUTH ST # 200, HERNANDO, MS 38632-2265
(662) 469-3277
(662) 912-9918
Mailing address
165 W SOUTH ST # 200, HERNANDO, MS 38632-2265
(662) 469-3277
(662) 912-9918
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA0621
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA0621
MS DEPT OF HEALTH
MS
Enumeration date
08/21/2015
Last updated
08/21/2015
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