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BLANCHE FOSHEE' PETTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
730 GOODMAN RD E STE B, SOUTHAVEN, MS 38671-9530
(662) 649-6087
Mailing address
730 GOODMAN RD E STE B, SOUTHAVEN, MS 38671-9530
(662) 649-6087

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
109301
MS
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
18870
TN

Other

Enumeration date
08/27/2014
Last updated
09/29/2025
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