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Individual

MISTY D. MAYFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2514 67TH AVENUE LOOP, SUITE 112, MERIDIAN, MS 39307-7259
(601) 553-0707
(601) 553-0775
Mailing address
PO BOX 2839, MERIDIAN, MS 39302-2839
(601) 553-0707
(601) 553-0775

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R864583
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09076220
MS
Enumeration date
02/02/2011
Last updated
04/25/2013
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