Individual
VIRGINIA HENLEY MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-2000
Mailing address
969 LAKELAND DR, JACKSON, MS 39216-4606
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905454
MS
Other
Enumeration date
07/20/2022
Last updated
11/05/2024
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