Individual
JENNIFER P LAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5334 DALE DR, MARION, MS 39342-9604
(601) 703-0130
(601) 703-0133
Mailing address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R853017
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07206011
—
MS
Enumeration date
10/31/2008
Last updated
11/06/2013
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