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General NPI Number Information
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NPI Number | 1972044048
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Entity Type | Organization
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Legal Business Name | DEWONA FLOWERS
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 604 LEXINGTON CV
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City | BYRAM
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State | MS
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Zip | 39272-3004
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Country | US
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Telephone | 601-259-4771
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Fax |
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Provider Business Mailing Address
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Address Line | 604 LEXINGTON CV
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City | BYRAM
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State | MS
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Zip | 39272-3004
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Country | US
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Telephone | 601-259-4771
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DEWONA FLOWERS
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Credential |
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Telephone | 601-259-4771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number | 901392
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License Number State | MS
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