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Organization

JACKSON PUBLIC SCHOOLS CLAUSELL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMY DARLENE CROCKER R.N. (LEAD NURSE)
(601) 209-4456
Entity
Organization

Contact information

Practice address
618 S PRESIDENT ST, JACKSON, MS 39201-5601
(601) 960-8705
Mailing address
3330 HARLEY ST, JACKSON, MS 39209-7239
(601) 960-8705

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
R557579
MS
261QS1000X
Student Health Clinic/Center
Primary

Other

Enumeration date
08/13/2008
Last updated
08/13/2008
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