Individual
JACINTA STEGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
848 S MADISON ST, TUPELO, MS 38801-4905
(662) 844-4177
Mailing address
4215 15TH ST, GULFPORT, MS 39501-2523
(228) 863-5211
(228) 863-4041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
901497
MS
Other
Enumeration date
07/09/2016
Last updated
04/26/2021
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