Organization
NURSE PRACTITIONER HOUSE CALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WENDELL T CARNEY (FNP)
(601) 513-8508
Entity
Organization
Contact information
Practice address
109 E DONALD ST, QUITMAN, MS 39355-2310
(601) 513-8508
(601) 557-4181
Mailing address
PO BOX 838, QUITMAN, MS 39355-0838
(601) 513-8508
(601) 557-4181
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
862287
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
862287
MS FNP LICENSE
MS
Enumeration date
10/18/2017
Last updated
01/18/2023
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