Individual
SANDRA FLINT MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1241 S MOUND ST STE A, GRENADA, MS 38901-4515
(662) 226-3711
Mailing address
1241 S MOUND ST STE A, GRENADA, MS 38901-4515
(662) 226-3711
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R696943
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06777358
—
MS
Enumeration date
02/22/2007
Last updated
08/27/2008
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