Individual
MRS. BRENDA L SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1500 E WOODROW WILSON AVE, NONE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1357
Mailing address
4150 S SIWELL RD, NONE, JACKSON, MS 39212-6209
(601) 362-4471
(601) 364-1357
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R856673
MS
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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