Individual
KATIE ANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5482 HIGHWAY 15 N, ECRU, MS 38841-8471
(662) 488-8799
Mailing address
537 FORD AVE, GUNTOWN, MS 38849-7915
(662) 822-5117
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906501
MS
Other
Enumeration date
02/05/2024
Last updated
02/12/2024
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