person
Manivanh A Prudhomme, MSN,FNP-BC,AGACNP-
Family Nurse Practitioner in Vicksburg, Mississippi
NPI 1144831140

Manivanh A Prudhomme is a Family Nurse Practitioner based in Vicksburg, MS and is specialized in Family. Manivanh A Prudhomme practices in Vicksburg, MS and has the professional credentials of MSN,FNP-BC,AGACNP-. The NPI Number for Manivanh A Prudhomme is 1144831140 and holds a License No. 904068 (Mississippi).

The current practice location address for Manivanh A Prudhomme is 2011 Highway 61 N, Vicksburg, MS and can be reached out via phone at 014-562-2776 and via fax at 601-456-2622.

Location: 2011 Highway 61 N, Vicksburg, MS, 39183
person
Provider Profile Details
NPI Number
1144831140
Provider Name
Manivanh A Prudhomme
Credential
MSN,FNP-BC,AGACNP-
Provider Entity Type
Individual
Gender
Female
Address
2011 Highway 61 N, Vicksburg, MS, 39183
Phone Number
014-562-2776
Fax Number
601-456-2622
Provider Enumeration Date
08/12/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2011 Highway 61 N
City
State
Zip
39183-3918
Phone Number
014-562-2776
Fax Number
601-456-2622
person
Provider Business Mailing Address Details
Address
2011 Highway 61 N
City
State
Zip
39183-3918
Phone Number
014-562-2776
Fax Number
601-456-2622
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
904068 (Mississippi)
Definition
Definition to come...
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