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General NPI Number Information
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NPI Number | 1073144333
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Entity Type | Individual
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Provider Name | BOQIN HU FNP
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 3446 BIG RIDGE RD
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City | DIBERVILLE
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State | MS
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Zip | 39540-2421
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Country | US
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Telephone | 228-386-1185
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Fax |
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Provider Business Mailing Address
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Address Line | 14060 OLD AVERA RD
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City | STATE LINE
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State | MS
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Zip | 39362-7112
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Country | US
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Telephone | 601-381-7218
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 903772
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License Number State | MS
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