Individual
JENNIFER RHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2680
(601) 815-3322
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2680
(601) 815-3322
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R861851
MS
363LP0200X
Pediatric Nurse Practitioner
R861851
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07457565
—
MS
01
—
P00716727
RAILROAD MEDICARE
MS
Enumeration date
10/18/2007
Last updated
07/22/2009
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