Individual
AMANDA MCKENZIE CESARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPNP, PC, PMHS
Contact information
Practice address
4881 HIGHWAY 589, SUMRALL, MS 39482-4453
(601) 336-9099
(601) 550-6184
Mailing address
PO BOX 566, SUMRALL, MS 39482-0566
(601) 467-6513
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R879886
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03574867
—
MS
Enumeration date
05/26/2015
Last updated
04/28/2025
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