PORTIA F TRAVIS

CLINTON, MS
NPI1710161708
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  R800172)
Enumeration Date2007-12-26
Last Update Date2007-12-26
Business Address
-- PORTIA F TRAVIS NP
206 LONGWOOD DR
CLINTON, MS 39056-5436
Phone number: 601-214-2045
Mailing Address
-- PORTIA F TRAVIS NP
514H E WOODROW WILSON AVE
JACKSON, MS 39216-4538
Phone number: 601-713-3900