Individual
DESARAE CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 W WILLIE MORRIS PKWY, YAZOO CITY, MS 39194-7702
(662) 746-5712
Mailing address
635 W WILLIE MORRIS PKWY, YAZOO CITY, MS 39194-7702
(662) 746-5712
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336497
MS
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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