Individual
DEIDRE L CALLICUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 LAUREL CV, OXFORD, MS 38655-2116
(662) 550-1074
Mailing address
114 LAUREL CV, OXFORD, MS 38655-2116
(662) 550-1074
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334924
MS
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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