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Individual

MAMIE WARREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, MSN, M.MED

Contact information

Practice address
206 HIGHWAY 12 E, HOLLANDALE, MS 38748-3822
(662) 347-2513
(662) 807-5052
Mailing address
PO BOX 611, HOLLANDALE, MS 38748-0611
(662) 347-2513
(662) 807-5052

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R745796
MS
163WC1500X
Community Health Registered Nurse
R745796
MS
163WC1600X
Continuing Education/Staff Development Registered Nurse
R745796
MS
163WS0200X
School Registered Nurse
R745796
MS
174H00000X
Health Educator
R745796
MS

Other

Enumeration date
06/13/2019
Last updated
06/13/2019
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