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General NPI Number Information
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NPI Number | 1144959420
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Entity Type | Individual
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Provider Name | ELIZABETH JOLLY
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Gender | Female
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 2368 DRAKE CV W
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City | HERNANDO
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State | MS
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Zip | 38632-6942
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Country | US
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Telephone | 901-633-8189
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 WIRT RD
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City | OAKLAND
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State | TN
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Zip | 38060-3337
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Country | US
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Telephone |
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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 | 175M00000X
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Taxonomy Name | Lay Midwife
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License Number |
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License Number State |
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