Individual
MISS DENNETTA DELORISE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4635 HIGHWAY 80 E, PEARL, MS 39208-4226
(601) 936-3833
Mailing address
353 KINGS RIDGE CIRCLE, BRANDON, MS 39047
(601) 500-2838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R870784
MS
Other
Enumeration date
08/15/2014
Last updated
12/08/2014
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