Individual
MRS. TAMMY Z JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
716 S MAIN ST, RIPLEY, MS 38663-2909
(662) 837-1534
(662) 837-3274
Mailing address
716 S MAIN ST, RIPLEY, MS 38663-2909
(662) 837-1534
(662) 837-3274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R613401
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112669
—
MS
Enumeration date
12/05/2005
Last updated
03/17/2014
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