Individual
COURTNEY LEIGH PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11516 LAMEY BRIDGE RD STE I, DIBERVILLE, MS 39540
(228) 207-4190
Mailing address
11516 LAMEY BRIDGE RD STE I, DIBERVILLE, MS 39540-2725
(228) 207-4190
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902637
MS
Other
Enumeration date
07/18/2018
Last updated
11/16/2018
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