Individual
MIRANDA M THURMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3522 FONTAINE AVE, JACKSON, MS 39213-5657
(601) 564-3012
Mailing address
3522 FONTAINE AVE, JACKSON, MS 39213-5657
(601) 564-3012
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
906212
MS
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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