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Individual

MISTI HEDGEPETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1501 ASTON AVE, MCCOMB, MS 39648-2734
(601) 249-5510
(601) 249-4242
Mailing address
PO BOX 490, MCCOMB, MS 39649-0490
(601) 250-4366
(601) 250-4367

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902897
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04022584
MS
Enumeration date
09/11/2018
Last updated
07/02/2021
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