Individual
DEANA TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
604 S MAIN ST, WATER VALLEY, MS 38965-3468
(662) 473-1311
Mailing address
600 COUNTY ROAD 99, WATER VALLEY, MS 38965-6156
(662) 473-8118
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903355
MS
Other
Enumeration date
06/02/2019
Last updated
02/21/2020
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