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Colby Ponder
Psychiatric/Mental Health Nurse Practitioner in Houston, Mississippi
NPI 1023572294

Colby Ponder is a Psychiatric/Mental Health Nurse Practitioner based in Tupelo, MS and is specialized in Psychiatric/Mental Health. Colby Ponder practices in Houston, MS. The NPI Number for Colby Ponder is 1023572294 and holds a License No. 903137 (Mississippi).

The current practice location address for Colby Ponder is 105 W Hamilton St, Houston, MS and can be reached out via phone at 662-598-8141 and via fax at 662-796-3126.

Location: 105 W Hamilton St, Houston, MS, 38804-6942
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023572294
Provider Name
Colby Ponder
Credential
Provider Entity Type
Individual
Gender
Male
Address
105 W Hamilton St, Houston, MS, 38804-6942
Phone Number
662-598-8141
Fax Number
662-796-3126
Provider Enumeration Date
01/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00018203 05 MS
institution
Provider Business Practice Location Address Details
Address
105 W Hamilton St
City
Houston
State
Mississippi
Zip
38851-2209
Phone Number
662-598-8141
Fax Number
662-796-3126
person
Provider Business Mailing Address Details
Address
105 W Hamilton St
City
Houston
State
Mississippi
Zip
38851-2209
Phone Number
662-598-8141
Fax Number
662-796-3126
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
903137 (Mississippi)
Definition
Definition to come...
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