Individual
MS. LORETTA JEAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
571 MITCHELL ROAD, GUNTOWN, MS 38849
(662) 348-2002
(662) 348-2001
Mailing address
PO BOX 156, GUNTOWN, MS 38849-0156
(662) 348-2002
(662) 348-2001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855649
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00631368
—
MS
Enumeration date
12/03/2007
Last updated
05/10/2013
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