Individual
CARLY JO MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1601 STRONG AVE, GREENWOOD, MS 38930-4037
(662) 451-7565
Mailing address
500 E JEFF DAVIS AVE, GREENWOOD, MS 38930-2318
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R885265
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04734769
—
MS
Enumeration date
10/05/2010
Last updated
06/20/2011
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