Individual
PANDORA REDMOND-WILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
749 MAIN ST, GREENVILLE, MS 38701-4108
(662) 335-5554
(662) 335-5580
Mailing address
PO BOX 4580, GREENVILLE, MS 38704-4580
(662) 822-1924
(662) 335-5580
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
MS
372600000X
Adult Companion
—
MS
376J00000X
Homemaker
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06908787
—
MS
05
—
07331397
—
MS
05
—
08679792
—
MS
Enumeration date
05/23/2019
Last updated
11/27/2023
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