Individual
BRENDA NAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
999 MARTIN LUTHER KING DRIVE, KOSCIUSKO, MS 39090
(662) 289-2351
Mailing address
30169 ATTALA HWY 19, WEST, MS 39192-7922
(662) 289-2351
(662) 289-2387
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R672211
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124021
—
MS
Enumeration date
02/06/2007
Last updated
07/09/2007
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