Individual
TERESA M SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1507 W QUITMAN ST, IUKA, MS 38852-1132
(662) 423-1000
(662) 423-1906
Mailing address
1507 W QUITMAN ST, IUKA, MS 38852-1132
(662) 423-1000
(662) 423-1906
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R782537
MS
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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