Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | R866837 | MS |
NPI | 1053665232 |
---|---|
Provider Name | Ms. Larona Rachelle Searcy |
First Address | Madison, MS 39110-8751 |
Second Address | Madison, MS 39110-8751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2012 |
Last Update Date | 01/08/2019 |