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General NPI Number Information
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NPI Number | 1790067486
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Entity Type | Individual
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Provider Name | ABBY SUTTON FNP C
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Gender | Female
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 70 MEDICAL PLZ
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City | EUPORA
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State | MS
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Zip | 39744-4018
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Country | US
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Telephone | 662-258-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 911 TYLER DR
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City | TUPELO
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State | MS
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Zip | 38801-5745
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Country | US
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Telephone | 662-680-9368
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Fax | 662-842-4709
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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 | R619264
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R619264
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License Number State | MS
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