Individual
MISS VANESSA F MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9423 LORRIE LN, OLIVE BRANCH, MS 38654-6529
(901) 831-6081
Mailing address
9423 LORRIE LN, OLIVE BRANCH, MS 38654-6529
(901) 831-6081
Taxonomy
Speciality
Code
Description
License number
State
163WE0900X
Enterostomal Therapy Registered Nurse
Primary
867627
MS
Other
Enumeration date
12/09/2018
Last updated
12/09/2018
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