Godbold, Jennifer Sumrall

Godbold, Jennifer Sumrall is an individual health care provider with primary practice located at 2500 North State Street Surgery, Jackson MS 39216. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Godbold, Jennifer Sumrall can be contacted via phone (601) 984-5678.

Contact Information

Primary practice address
2500 North State Street Surgery Jackson MS 39216
Phone: (601) 984-5678
Fax: (601) 984-5638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R865457 Mississippi

Profile Details

NPI number 1073797338
LBN Legal business name Godbold, Jennifer Sumrall
Credentials APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2007
Last updated Dec 16th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073797338 NPPES
Mississippi MEDICAID 05956046

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