Individual
MRS. MANDY H WINDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1746 C MS STATE HWY 1 SOUTH, GREENVILLE, MS 38701-6304
(662) 743-9809
(662) 743-9811
Mailing address
120 STONE CREEK BLVD, STE 500, FLOWOOD, MS 39232-8205
(769) 235-2941
(601) 939-2211
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R872654
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R872654
LICENSE
MS
Enumeration date
10/05/2011
Last updated
05/12/2016
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