Individual
JESSICA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Contact information
Practice address
92 RATLIFF ST STE A, LUCEDALE, MS 39452-6537
(601) 947-8181
Mailing address
92 RATLIFF ST STE A, LUCEDALE, MS 39452-6537
(601) 947-8181
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
904825
MS
Other
Enumeration date
08/07/2021
Last updated
08/31/2021
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