Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | R724394 | MS |
NPI | 1023249497 |
---|---|
Provider Name | Ms. Lynn Ann Vincent |
First Address | Jackson, MS 39216-4635 |
Second Address | Jackson, MS 39216-4635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 11/01/2021 |