Individual
QYHDIJHA IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
876 SUNFLOWER RD, SCOOBA, MS 39358-7372
(601) 409-6076
Mailing address
876 SUNFLOWER RD, SCOOBA, MS 39358-7372
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
920750
MS
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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