person
Mrs. Lisa Lathem, NP
Family Nurse Practitioner in Jackson, Mississippi
NPI 1710210794

Lisa Lathem is a Family Nurse Practitioner based in Jackson, MS and is specialized in Family. Lisa Lathem practices in Jackson, MS and has the professional credentials of NP. The NPI Number for Lisa Lathem is 1710210794 and holds a License No. R672106 (Mississippi).

The current practice location address for Lisa Lathem is 971 Lakeland Dr, Jackson, MS and can be reached out via phone at 601-200-4560 and via fax at 601-326-4632.

Location: 971 Lakeland Dr, Jackson, MS, 39225-3666
person
Provider Profile Details
NPI Number
1710210794
Provider Name
Lisa Lathem
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
971 Lakeland Dr, Jackson, MS, 39225-3666
Phone Number
601-200-4560
Fax Number
601-326-4632
Provider Enumeration Date
09/09/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P01410915 01 MS RAILROAD MEDICARE
05721214 05 MS
institution
Provider Business Practice Location Address Details
Address
971 Lakeland Dr
City
State
Zip
39216-4643
Phone Number
601-200-4560
Fax Number
601-326-4632
person
Provider Business Mailing Address Details
Address
971 Lakeland Dr
City
State
Zip
39216-4643
Phone Number
601-200-4560
Fax Number
601-326-4632
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R672106 (Mississippi)
Definition
Definition to come...
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