Organization
MICAH A LADNER FNP-C LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH ANTHONY LADNER FNP (OWNER)
(228) 493-3404
Entity
Organization
Contact information
Practice address
22549 FENTON DEDEAUX RD, KILN, MS 39556-6576
(228) 493-3404
(228) 493-3404
Mailing address
PO BOX 6571, DIAMONDHEAD, MS 39525-6501
(228) 493-3404
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901609
MS
Other
Enumeration date
05/26/2017
Last updated
05/26/2017
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