Harris, Misty M

Harris, Misty M is an individual health care provider with primary practice located at 9421 Eastside Drive Extention , Newton MS 39345. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Harris, Misty M can be contacted via phone (601) 683-0279.

Contact Information

Primary practice address
9421 Eastside Drive Extention Newton MS 39345
Phone: (601) 683-0279
Fax: (601) 683-0366
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R864994 Mississippi

Profile Details

NPI number 1679662928
LBN Legal business name Harris, Misty M
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Jul 8th, 2007 - about 19 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 1679662928 NPPES
Mississippi Other 640670312 TAX ID

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