Individual
MELISSA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6426
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6426
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R859309
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05789346
—
MS
Enumeration date
10/24/2006
Last updated
08/27/2013
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