Individual
RUTH C GADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
330 N BROAD ST, FOREST, MS 39074-3508
(601) 469-4771
(601) 469-4724
Mailing address
PO BOX 520, MARION, MS 39342-0520
(601) 646-7700
(888) 735-7202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R717142
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126171
—
MS
Enumeration date
06/09/2006
Last updated
11/18/2010
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