Individual
MRS. JESSIE LILLEY VAN ETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6380 CLINTON TINNIN RD, JACKSON, MS 39209-9119
(601) 978-0764
Mailing address
6380 CLINTON TINNIN RD, JACKSON, MS 39209-9119
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
908645
MS
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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