Individual
DR. ROXANNE LEE DECELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
228 CANEY FORD RD., POPLARVILLE, MS 39470
(228) 669-4250
Mailing address
228 CANEY FORD RD., POPLARVILLE, MS 39470
(228) 669-4250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
901748
MS
363LF0000X
Family Nurse Practitioner
Primary
901748
MS
363LF0000X
Family Nurse Practitioner
AP09168
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04885860
—
MS
Enumeration date
02/02/2017
Last updated
04/23/2021
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