Individual
MISTY GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
971 LAKELAND DR, SUITE 657, JACKSON, MS 39216-4643
(601) 200-5955
Mailing address
971 LAKELAND DR, SUITE 657, JACKSON, MS 39216-4643
(601) 200-5955
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R883198
MS
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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