Provider Demographics
NPI:1790342079
Name:ARLEDGE, JOSETTE DAVIDA (RN)
Entity Type:Individual
Prefix:
First Name:JOSETTE
Middle Name:DAVIDA
Last Name:ARLEDGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10545A HIGHWAY 494
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-8726
Mailing Address - Country:US
Mailing Address - Phone:601-604-1959
Mailing Address - Fax:
Practice Address - Street 1:10545A HIGHWAY 494
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-8726
Practice Address - Country:US
Practice Address - Phone:601-604-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR875029163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse