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1891218046
KENITRA WALLACE
NATCHEZ, MS
NPI
1891218046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS 902181)
Enumeration Date
2017-07-19
Last Update Date
2018-05-23
Business Address
KENITRA WALLACE FNP
145 HOMOCHITTO ST
NATCHEZ, MS 39120
Phone number: 601-442-4863
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Mailing Address
KENITRA WALLACE FNP
145 HOMOCHITTO ST
NATCHEZ, MS 39120-3906
Phone number: 601-442-4863
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