Individual
DEBORAH G HEADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
971 LAKELAND DR, SUITE 1250, JACKSON, MS 39216-4643
(601) 366-1011
(601) 366-7311
Mailing address
971 LAKELAND DR, SUITE 1250, JACKSON, MS 39216-4643
(601) 366-1011
(601) 366-7311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R748377
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R748377
NURSE LICENSE
MS
Enumeration date
10/20/2009
Last updated
10/20/2009
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