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Individual

JACKIE CLANTON MCDONALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP-C

Contact information

Practice address
10 PROVENCE BLVD, MADISON, MS 39110-8350
(601) 608-7213
(601) 608-7213
Mailing address
10 PROVENCE BLVD, MADISON, MS 39110-8350
(601) 608-7213
(601) 608-7213

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R863322
MS

Other

Enumeration date
09/29/2011
Last updated
03/30/2026
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