Individual
JENNIFER ROBIN LEGGETT-HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
603 S MAIN ST, MOUNT OLIVE, MS 39119-8902
(601) 797-3405
(601) 797-9482
Mailing address
603 S MAIN ST, MOUNT OLIVE, MS 39119-8902
(601) 797-3405
(601) 797-9482
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0610233
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07624895
—
MS
01
—
302I506890
MEDICARE PTAN
MS
Enumeration date
07/29/2010
Last updated
07/20/2015
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