Individual
MRS. DEERA WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671
(662) 772-3260
Mailing address
6576 PAYNE LN, OLIVE BRANCH, MS 38654-9192
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902552
MS
363LF0000X
Family Nurse Practitioner
F02180313
MS
Other
Enumeration date
05/10/2018
Last updated
07/11/2018
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