Baker, Mandy Mccoy

Baker, Mandy Mccoy is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Baker, Mandy Mccoy can be contacted via phone (601) 984-1000.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R882615 Mississippi

Profile Details

NPI number 1326302050
LBN Legal business name Baker, Mandy Mccoy
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2012
Last updated Nov 19th, 2012 - about 14 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 1326302050 NPPES
Mississippi MEDICAID 08103071

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