Individual
NORA CECELIA GOUGH-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
112 W PEELER AVE, SHAW, MS 38773-8710
(662) 754-3301
(662) 754-3304
Mailing address
112 W PEELER AVE, P.O. BOX 299, SHAW, MS 38773-8710
(662) 754-3301
(662) 754-3304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R872155
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09801514
—
MS
Enumeration date
07/27/2009
Last updated
04/14/2020
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