Individual
MICHELLE LORRAINE MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
975 HALL ST, WIGGINS, MS 39577-2107
(601) 528-9119
(601) 528-9193
Mailing address
PO BOX 419, WIGGINS, MS 39577-0419
(601) 528-9119
(601) 528-9193
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R865765
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02722269
—
MS
Enumeration date
09/21/2011
Last updated
01/21/2021
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