Individual
MRS. AUDREY DALE ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, MSN
Contact information
Practice address
777 HOLLY HILL DR, TUPELO, MS 38801-2340
(662) 432-1221
(888) 836-0702
Mailing address
777 HOLLY HILL DR, TUPELO, MS 38801-2340
(662) 432-1221
(888) 836-1221
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023001592
MP
Other
Enumeration date
10/02/2023
Last updated
01/30/2024
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