Individual
MS. THERESA BARRETT DUEITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Contact information
Practice address
1203 JEFFERSON ST, LAUREL, MS 39440-4354
(601) 649-2863
(601) 649-9479
Mailing address
1203 JEFFERSON ST, LAUREL, MS 39440-4354
(601) 649-2863
(601) 649-9479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R709271
MS
363LA2100X
Acute Care Nurse Practitioner
Primary
R709271
MS
363LA2200X
Adult Health Nurse Practitioner
R709271
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02277797
—
MS
01
—
4741566
CIGNA
MS
01
—
P00811329
RAILROAD MEDICARE
MS
Enumeration date
04/11/2007
Last updated
05/14/2013
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