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1215039953
AMY WALLACE SMITH
JACKSON, MS
NPI
1215039953
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R765697)
Enumeration Date
2006-09-02
Last Update Date
2007-07-08
Business Address
Mrs. AMY WALLACE SMITH N.P.
1500 E WOODROW WILSON AVE NURSING SERVICE (118)
JACKSON, MS 39216-5116
Phone number: 601-364-1300
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Mailing Address
Mrs. AMY WALLACE SMITH N.P.
1140 WINDROSE CIR
MADISON, MS 39110-7753
Phone number:
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