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1215476064
JONATHAN PRINCIOTTA
JACKSON, MS
NPI
1215476064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0222X Nurse Practitioner, Pediatrics, Critical Care
(Licence: MS 901958)
Enumeration Date
2017-02-13
Last Update Date
2017-04-05
Business Address
-- JONATHAN PRINCIOTTA
2500 N STATE ST 2500 NORTH STATE STREET
JACKSON, MS 39216-4500
Phone number: 601-815-6960
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Mailing Address
-- JONATHAN PRINCIOTTA
510 PINEBARK CV
BRANDON, MS 39047-4447
Phone number: 228-238-9187
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