Individual
MRS. DAVIN NISHA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1935 LAKELAND DR STE 900, JACKSON, MS 39216-5028
(601) 718-2468
Mailing address
1935 LAKELAND DR STE 900, JACKSON, MS 39216-5028
(601) 718-2468
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337628
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010109200119
—
MS
Enumeration date
05/07/2021
Last updated
05/07/2021
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