Humphries, Detra La'Quel
Humphries, Detra La'Quel is an individual health care provider with primary practice located at 1935 Lakeland Dr Ste 900 , Jackson MS 39216-5028. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Humphries, Detra La'Quel can be contacted via phone (601) 718-2487.Contact Information
Primary practice address
1935 Lakeland Dr Ste 900
Jackson MS 39216-5028
Phone: (601) 718-2487
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | R865122 | Mississippi |
Profile Details
| NPI number | 1033805569 |
|---|---|
| LBN Legal business name | Humphries, Detra La'Quel |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2023 |
| Last updated | Apr 17th, 2023 - about 3 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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