Individual
DENETTA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5429 ROBINSON ROAD EXT, JACKSON, MS 39204-4138
(601) 914-0163
Mailing address
5429 ROBINSON ROAD EXT, JACKSON, MS 39204-4138
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R868748
MS
Other
Enumeration date
04/28/2013
Last updated
12/17/2013
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