Individual
DELIONDRA ARCHIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
181 STULL RD, BRANDON, MS 39047-8266
(160) 150-3059
Mailing address
181 STULL RD, BRANDON, MS 39047-8266
(160) 150-3059
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901755
MS
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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