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1013080027
LISA DELORIS SLADE
HATTIESBURG, MS
NPI
1013080027
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R772518)
Enumeration Date
2006-11-16
Last Update Date
2015-01-09
Business Address
Mrs. LISA DELORIS SLADE FNP-BC
605 STADIUM DR
HATTIESBURG, MS 39401-4156
Phone number: 601-450-0310
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Mailing Address
Mrs. LISA DELORIS SLADE FNP-BC
PO BOX 1729
HATTIESBURG, MS 39403-1729
Phone number: 601-545-3700
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