Individual
JASMINE IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
320 MS-15, LOUISVILLE, MS 39339
(662) 773-7500
Mailing address
400 E GILLESPIE ST APT 128, STARKVILLE, MS 39759-5306
(601) 493-3943
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906976
MS
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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