Doctor Name: | MELISSA RUTH TOLAR |
NPI Number: | 1023346137 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R867942 |
Business Practice Address: | 6051 U S Highway 49 Hattiesburg, MS - 394017200 |
Business Phone Number: | 6012881212 |
Business Fax Number: | |
Mailing Address: | 88 Tolar Cut Off, COLUMBIA |
State: | MS |
Postal Code: | 394299645 |
Phone Number: | 6014080969 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2009 |
NPI Last Update Date: | 05/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R867942 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |