FRED ALLEN RAYBURN

TUPELO, MS
NPI1700437076
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  903556)
Enumeration Date2019-09-26
Last Update Date2019-09-26
Business Address
FRED ALLEN RAYBURN FNP - BC
848 S MADISON ST
TUPELO, MS 38801-4905
Phone number: 662-844-4177
Mailing Address
FRED ALLEN RAYBURN FNP - BC
4611 TOXISH RD
PONTOTOC, MS 38863-7080
Phone number: 662-488-5658
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