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MALLORY RAE VANDEVENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
4290 LAKELAND DR STE A, FLOWOOD, MS 39232-9571
(601) 932-0083
Mailing address
3000 VOLLEY CAMPBELL RD, TERRY, MS 39170-9057
(601) 201-0163

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905114
MS

Other

Enumeration date
02/17/2022
Last updated
02/17/2022
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