Individual
MRS. CLARA JEAN RUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1100 COLLEGE ST, COLUMBUS, MS 39701-5800
(662) 329-7289
Mailing address
2350 DOGWOOD DR, WEST POINT, MS 39773-9231
(662) 494-6125
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R532517
MS
Other
Enumeration date
10/12/2006
Last updated
04/16/2014
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