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1033805569
DETRA LA'QUEL HUMPHRIES
JACKSON, MS
NPI
1033805569
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: MS R865122)
Enumeration Date
2023-04-17
Last Update Date
2023-04-17
Business Address
Ms. DETRA LA'QUEL HUMPHRIES RN
1935 LAKELAND DR STE 900
JACKSON, MS 39216-5028
Phone number: 601-718-2487
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Mailing Address
Ms. DETRA LA'QUEL HUMPHRIES RN
1935 LAKELAND DR STE 900
JACKSON, MS 39216-5028
Phone number: 601-718-2487
Copy
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A PLUS HEALTHCARE LLC