NPI 1528829512

Larry Bourrage, RN

Practitioner Registered Nurse Collinsville, MS

Practice location

Address: 12485 Schamberville Ln, Collinsville, MS 39325-9195
Phone: (601) 480-4754

Registered specialties

Registered Nurse Primary

Nursing Service Providers Taxonomy 163W00000X Licence R890304 (MS)

Other Registered Nurse providers in Mississippi →

Registry record

NPI: 1528829512
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jan 2024
Record last updated: 17 Jan 2024

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.