NPI 1033805569
Detra La'Quel Humphries, RN
Practice location
- Address
- 1935 Lakeland Dr STE 900, Jackson, MS 39216-5028
- Phone
- (601) 718-2487
Registered specialties
Addiction (Substance Use Disorder) Registered Nurse
Primary
Registry record
- NPI
- 1033805569
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 17 Apr 2023
- Record last updated
- 17 Apr 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.