Individual
MARY YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-3000
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 663-0202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R882506
MS
Other
Enumeration date
10/14/2015
Last updated
10/30/2015
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