Individual
MRS. CHASSITY NICOLE VANDERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3550 HIGHWAY 468 W, WHITFIELD, MS 39193-5529
(601) 351-8000
(601) 351-8586
Mailing address
3550 HIGHWAY 468 W, WHITFIELD, MS 39193-5529
(601) 351-8000
(601) 351-8586
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R878942
MS
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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