Individual
REBECCA DOROUGH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
806 GARFIELD ST, TUPELO, MS 38801-5749
(662) 377-5395
(662) 377-5390
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R531707
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126576
—
MS
Enumeration date
05/31/2006
Last updated
07/08/2007
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