Individual
TERRY DORSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
510 HIGHWAY 322, CLARKSDALE, MS 38614-4717
(662) 624-4292
(662) 624-4354
Mailing address
800 OHIO AVE, CLARKSDALE, MS 38614-7200
(662) 624-2504
(662) 624-4354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R820198
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08156332
—
MS
Enumeration date
03/24/2014
Last updated
08/04/2014
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