Individual
KATHERINE G LOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
6295 OLD CANTON RD, APT 23B, JACKSON, MS 39211-2908
(601) 463-0676
Mailing address
6295 OLD CANTON RD, APT 23B, JACKSON, MS 39211-2908
(601) 463-0676
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R876755
MS
363LG0600X
Gerontology Nurse Practitioner
R876755
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01928036
—
MS
Enumeration date
09/13/2013
Last updated
01/27/2014
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