Individual
BRANSON HAL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-C
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4505
(601) 984-5500
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5500
(601) 984-5503
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
902794
MS
Other
Enumeration date
10/04/2018
Last updated
11/28/2018
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