Individual
LAQUISHA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
34 DOROTHY CV, JACKSON, TN 38305-1677
(731) 234-9687
Mailing address
34 DOROTHY CV, JACKSON, TN 38305-1677
(731) 234-9687
(731) 234-9687
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
164454
TN
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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