Provider Demographics
NPI:1285725838
Name:DOZIER, JENNIFER YUSON (NP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:YUSON
Last Name:DOZIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 11TH ST N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-3502
Mailing Address - Country:US
Mailing Address - Phone:205-270-2212
Mailing Address - Fax:
Practice Address - Street 1:606 NORTH JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MS
Practice Address - Zip Code:39341
Practice Address - Country:US
Practice Address - Phone:662-726-4264
Practice Address - Fax:662-726-4204
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR873848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06184228Medicaid
MS06184228Medicaid
MSQ29811Medicare UPIN