Provider Demographics
NPI:1114173796
Name:STRONG, MARY CARTER (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CARTER
Last Name:STRONG
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 23996
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-3996
Mailing Address - Country:US
Mailing Address - Phone:601-206-6100
Mailing Address - Fax:601-206-6052
Practice Address - Street 1:1040 RIVER OAKS DR
Practice Address - Street 2:SUITE103
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9530
Practice Address - Country:US
Practice Address - Phone:601-326-2599
Practice Address - Fax:601-933-0852
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSR866163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily