Individual
RIKKI SUZANNE BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
4881 HWY 589, SUMRALL, MS 39482-3948
(601) 336-9099
Mailing address
PO BOX 566, SUMRALL, MS 39482-0566
(601) 336-9099
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
906303
MS
Other
Enumeration date
09/27/2023
Last updated
02/17/2025
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