Individual
TRACY HENNESSEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
404 MAIN ST, NEW AUGUSTA, MS 39462-0000
(601) 964-8391
(601) 964-8393
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 582-5461
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R854915
MS
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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