Individual
REBECCA B CLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 364-1558
(601) 368-3802
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 364-1558
(601) 368-3802
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R859995
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05509571
—
MS
Enumeration date
03/31/2006
Last updated
09/16/2008
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