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General NPI Number Information
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NPI Number | 1942825088
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Entity Type | Individual
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Provider Name | ROCHELSEY MCDONALD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 185 HOLMAR DR
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City | BRANDON
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State | MS
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Zip | 39047-9550
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Country | US
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Telephone | 601-416-4332
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4174
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City | BRANDON
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State | MS
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Zip | 39047-4174
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Country | US
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Telephone | 601-416-4332
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903461
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License Number State | MS
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