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General NPI Number Information
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NPI Number | 1508553512
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Entity Type | Individual
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Provider Name | JENNIFER ANN FLOYD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 3747 HIGHWAY 51 S
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City | SENATOBIA
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State | MS
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Zip | 38668-2942
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Country | US
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Telephone | 662-612-4549
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Fax | 662-301-8596
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Provider Business Mailing Address
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Address Line | 5133 COONEWAH TRL
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City | TUPELO
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State | MS
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Zip | 38801-6947
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Country | US
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Telephone | 225-678-6567
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 905865
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License Number State | MS
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