IndividualActive
Detra Humphries, RN
NPI 1033805569 · Addiction (Substance Use Disorder) Registered Nurse · Jackson, MS
Provider details
- NPI number
- 1033805569
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- R865122 (MS)
Specialties & taxonomies
Nursing Service Providers
Practice location
1935 Lakeland Dr Ste 900
Jackson, MS 39216-5028
Phone: (601) 718-2487
Approximate (ZIP-level) locationGet directions
Mailing address
1935 Lakeland Dr Ste 900
Jackson, MS 39216-5028
Registry dates
- Enumerated
- 2023-04-17
- Last updated
- 2023-04-17
- Certified
- 2023-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.