Provider Demographics
NPI:1427159839
Name:SARTIN, MARY KATHLEEN (CFNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATHLEEN
Last Name:SARTIN
Suffix:
Gender:F
Credentials:CFNP
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Mailing Address - Street 1:1020 RIVER OAKS DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9500
Mailing Address - Country:US
Mailing Address - Phone:601-936-1400
Mailing Address - Fax:601-936-0671
Practice Address - Street 1:1020 RIVER OAKS DR
Practice Address - Street 2:SUITE 320
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39232-9500
Practice Address - Country:US
Practice Address - Phone:601-936-1400
Practice Address - Fax:601-936-0671
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MSR865558363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSR865558OtherREGISTERED NURSE LICENSE