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General NPI Number Information
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NPI Number | 1306449301
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Entity Type | Individual
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Provider Name | JAZZMEN BRISCOE LMT #2540
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Gender | Female
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 226 N BIERDEMAN RD
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City | PEARL
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State | MS
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Zip | 39208-4611
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Country | US
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Telephone | 601-526-1444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82
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City | CLINTON
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State | MS
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Zip | 39060-0082
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Country | US
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Telephone | 769-798-3089
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number |
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 246Y00000X
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Taxonomy Name | Health Information Specialist/Technologist
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License Number |
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2540
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License Number State | MS
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