Individual
ALEX BARRAZA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-6960
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-6960
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
901350
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09482518
—
MS
Enumeration date
11/11/2015
Last updated
02/04/2016
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