Individual
MRS. SHARON DIETRICH MCELWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5214
(601) 984-2292
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5214
(601) 984-2292
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R883365
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07235716
—
MS
Enumeration date
07/01/2006
Last updated
06/12/2015
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