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1174980478
AISHA RENEA OUTLAW
STARKVILLE, MS
NPI
1174980478
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R866124)
Enumeration Date
2016-01-19
Last Update Date
2016-01-19
Business Address
-- AISHA RENEA OUTLAW FNP
400 HOSPITAL RD
STARKVILLE, MS 39759-2163
Phone number: 662-323-4320
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Mailing Address
-- AISHA RENEA OUTLAW FNP
103 EUDORA WELTY DRIVE J-02
STARKVILLE, MS 39759-2163
Phone number: 662-769-9781
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