Individual
TARALYNN MAOTI FELTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
759 WICKLOW PL UNIT B, RIDGELAND, MS 39157-1238
(769) 216-7186
Mailing address
759 WICKLOW PL UNIT B, RIDGELAND, MS 39157-1238
(769) 216-7186
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P330494
MS
Other
Enumeration date
02/23/2019
Last updated
02/23/2019
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