Individual
JENSEN CIACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1002 JEFFERSON STREET, STE 400, LAUREL, MS 39440
(601) 649-7802
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
10/04/2024
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