Individual
CHRISTINE MCFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
859495
MS
363LF0000X
Family Nurse Practitioner
Primary
901630
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07003841
—
MS
Enumeration date
12/14/2016
Last updated
03/13/2017
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