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1710161708
PORTIA F TRAVIS
CLINTON, MS
NPI
1710161708
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R800172)
Enumeration Date
2007-12-26
Last Update Date
2007-12-26
Business Address
-- PORTIA F TRAVIS NP
206 LONGWOOD DR
CLINTON, MS 39056-5436
Phone number: 601-214-2045
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Mailing Address
-- PORTIA F TRAVIS NP
514H E WOODROW WILSON AVE
JACKSON, MS 39216-4538
Phone number: 601-713-3900
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