Individual
JENNIFER HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,NNP,NCC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
R899176
MS
Other
Enumeration date
03/24/2015
Last updated
06/04/2015
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