Healthcare Provider Details

I. General information

NPI: 1316070899
Provider Name (Legal Business Name): MARIANNE DAY WHARTON CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 MEDICAL CENTER DR
BATESVILLE MS
38606-8608
US

IV. Provider business mailing address

505 SUMMERSET DR
OXFORD MS
38655-2232
US

V. Phone/Fax

Practice location:
  • Phone: 662-563-7873
  • Fax: 662-563-8129
Mailing address:
  • Phone: 662-513-0696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR861045
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: