Individual
JULIE VANSICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP, PMHNP
Contact information
Practice address
969 LAKELAND DR, ST. THOMAS HALL, JACKSON, MS 39216-4606
(601) 200-3110
(601) 200-3109
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-3110
(601) 200-3109
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R710539
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08259846
—
MS
Enumeration date
09/28/2006
Last updated
03/08/2011
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