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Individual

IVY LONDON SMOTHERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1000 ASU DR, LORMAN, MS 39096-7510
(601) 877-6100
Mailing address
345 MARIAN LN, VICKSBURG, MS 39183-2867
(601) 831-7544

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07210326
MS

Other

Enumeration date
07/29/2009
Last updated
07/06/2021
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