Provider Demographics
NPI:1508906629
Name:MESSER, ALICE F (CFNP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:F
Last Name:MESSER
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:F
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:2470 FLOWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:877-554-4257
Mailing Address - Fax:601-983-2845
Practice Address - Street 1:2470 FLOWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:877-554-4257
Practice Address - Fax:601-983-2845
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR783059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05930307Medicaid
MS500001400Medicare PIN
MS500001400Medicare ID - Type Unspecified
MS05930307Medicaid