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Organization

DELTA REGIONAL MEDICAL CENTER-WEST CAMPUS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA WILLIS LPC (DIRECTOR)
(662) 822-2186
Entity
Organization

Contact information

Practice address
300 S WASHINGTON AVE, GREENVILLE, MS 38701-4719
(662) 378-2020
(662) 725-2505
Mailing address
300 S WASHINGTON AVE, GREENVILLE, MS 38701-4719
(662) 378-2020
(662) 725-2200

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
09/30/2019
Last updated
09/30/2019
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