Individual
MRS. JENNIFER HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2149 STATELINE RD W, SOUTHAVEN, MS 38671-1222
(662) 342-1112
(662) 393-1478
Mailing address
2149 STATELINE RD W DEPT 1102, SOUTHAVEN, MS 38671-1222
(662) 342-1112
(662) 393-1478
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906936
MS
Other
Enumeration date
09/12/2024
Last updated
10/11/2024
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