Individual
MONIFA RI'ANA BEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
514H E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 713-3900
Mailing address
361 HANGING MOSS CIR, JACKSON, MS 39206-4602
(601) 366-7016
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R872486
MS
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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