Individual
ASHLEY LAWRENCE BOZEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACPNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2001
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
903259
MS
363LP0200X
Pediatric Nurse Practitioner
Primary
904868
MS
Other
Enumeration date
03/20/2019
Last updated
11/02/2021
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