Individual
MRS. DORTHA LEONA CARNATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
910 MARY VANCE DR, TUPELO, MS 38801
(662) 377-6275
(662) 377-6299
Mailing address
910 MARY VANCE DR, TUPELO, MS 38801
(662) 377-6275
(662) 377-6299
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R582581
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500263208
—
MS
Enumeration date
04/02/2008
Last updated
05/16/2016
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