Individual
ANNA D WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
501 MARSHALL STREET, SUITE 200, JACKSON, MS 39202
(601) 914-9503
(601) 914-6174
Mailing address
501 MARSHALL STREET, SUITE 200, JACKSON, MS 39202
(601) 914-9503
(601) 914-6174
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R873502
MS
Other
Enumeration date
08/15/2010
Last updated
03/02/2011
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