Individual
JANICE GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4109 HWY 98 WEST, SUMMIT, MS 39666
(888) 490-9107
(502) 243-2225
Mailing address
4109 HWY 98 WEST, SUMMIT, MS 39666
(888) 490-9107
(502) 243-2225
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R718211
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116466
—
MS
01
—
202011213A
BLUE CROSS
MS
Enumeration date
06/15/2006
Last updated
04/06/2016
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