Individual
LEKENYA MIRIAM NUTTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
415 US HIGHWAY 49 N, TUTWILER, MS 38963-5091
(662) 345-6567
Mailing address
PO BOX 46, RULEVILLE, MS 38771-0046
(662) 402-2351
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903390
MS
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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