Larry, Zenotha

Larry, Zenotha is an individual health care provider with primary practice located at 3502 W Northside Dr , Jackson MS 39213-4454. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Larry, Zenotha can be contacted via phone (601) 362-5321.

Contact Information

Primary practice address
3502 W Northside Dr Jackson MS 39213-4454
Phone: (601) 362-5321
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X R877587 Mississippi

Profile Details

NPI number 1659615557
LBN Legal business name Larry, Zenotha
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2012
Last updated May 16th, 2016 - about 10 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 1659615557 NPPES
Mississippi Other R877587 MISSISSIPPI

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