Individual
JESSICA BOSWELL MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-6721
Mailing address
10361 ROAD 280, PHILADELPHIA, MS 39350-5243
(601) 416-1449
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R874333
MS
Other
Enumeration date
09/30/2010
Last updated
10/29/2018
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