Individual
CANDANCE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4635 HIGHWAY 80 E, PEARL, MS 39208-4226
(601) 825-7280
(601) 825-8130
Mailing address
PO BOX 24116, JACKSON, MS 39225-4116
(601) 825-7280
(601) 825-8130
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R873292
MS
Other
Enumeration date
09/04/2014
Last updated
10/14/2016
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