Basic Information
| Provider Information | |||||||||
| NPI: | 1023357274 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRETT | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 180367 | ||||||||
| Address2: | |||||||||
| City: | RICHLAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392180367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019326400 | ||||||||
| FaxNumber: | 6019326437 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 HIGHWAY 49 S | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | RICHLAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392189425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019326400 | ||||||||
| FaxNumber: | 6019326437 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2013 | ||||||||
| LastUpdateDate: | 02/07/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R888688 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.