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General NPI Number Information
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NPI Number | 1003840646
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Entity Type | Individual
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Provider Name | CARYL P. SUMRALL FNP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 6311 RIDGEWOOD RD
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City | JACKSON
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State | MS
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Zip | 39211-2035
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Country | US
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Telephone | 601-952-8398
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Fax | 833-972-5586
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Provider Business Mailing Address
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Address Line | 6311 RIDGEWOOD RD
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City | JACKSON
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State | MS
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Zip | 39211-2035
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Country | US
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Telephone | 601-952-8398
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Fax | 833-972-5586
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R857389
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License Number State | MS
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