Individual
PAIGE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5482 MS-15, ECRU, MS 38841
(662) 488-8799
Mailing address
5482 MS-15, ECRU, MS 38841
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905800
MS
Other
Enumeration date
02/22/2023
Last updated
08/03/2023
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