Individual
MRS. MARY MELVIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
107 CANNON RUN, CANTON, MS 39046-8033
(601) 624-6272
Mailing address
2500 N STATE ST, JMM SUITE 2525, JACKSON, MS 39216-4500
(601) 815-9528
(601) 984-6439
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
901700
MS
Other
Enumeration date
01/12/2018
Last updated
04/10/2018
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