Individual
LILLIAN CLAIBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
604 APPLEGATE ST, WINONA, MS 38967
(663) 803-9661
Mailing address
604 APPLEGATE ST, WINONA, MS 38967
(663) 803-9661
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
800431801
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
871311749
TRANSPORTATION
MS
Enumeration date
11/01/2021
Last updated
11/01/2021
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