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Contact Information

SUPERIOR SOLES
1888 MAIN ST
MADISON, MS39110
 Phone: 601-503-0335
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Clinic/Center

261Q00000X
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for SUPERIOR SOLES · (Female)

NPI # 1104466887
Status Active
Credentials
Entity Individual
Enumeration date 01/10/2020
Last updated 01/10/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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