Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A810395 | MS |
NPI | 1003114257 |
---|---|
Provider Name | Mrs. Rachel Jamison Sledge |
First Address | Oxford, MS 38655-5371 |
Second Address | Oxford, MS 38655-5371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2011 |
Last Update Date | 10/03/2011 |