Individual
NASHAMBA JACKSON-BRACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4490 HIGHWAY 80 E STE A, PEARL, MS 39208-4213
(601) 337-8900
Mailing address
4490 HIGHWAY 80 E STE A, PEARL, MS 39208-4213
(601) 337-8900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
881624
MS
363LF0000X
Family Nurse Practitioner
Primary
F0815355
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740742329
GROUP NUMBER
MS
Enumeration date
10/18/2016
Last updated
04/14/2019
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