Individual
CHANDLER MIMS DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 OFFICE PARK DR STE A, OXFORD, MS 38655-3546
(662) 638-3412
Mailing address
212 OLDE CASTLE LOOP, OXFORD, MS 38655-6012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
901117
MS
363LF0000X
Family Nurse Practitioner
Primary
904927
MS
Other
Enumeration date
04/23/2020
Last updated
10/19/2021
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