Individual
JACKIE EVETTE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 CHURCH RD W, SOUTHAVEN, MS 38671-7144
(662) 253-1067
Mailing address
PO BOX 306415, NASHVILLE, TN 37230-6415
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906591
MS
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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