Individual
MRS. JESSICA BRADDOCK CHILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
1265 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6749
(662) 407-2544
(662) 620-9915
Mailing address
1265 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6749
(662) 407-2544
(662) 620-9915
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R874853
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
905426
MS
Other
Enumeration date
10/18/2019
Last updated
10/14/2022
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