Provider Demographics
NPI:1023357274
Name:GARRETT, DONALD J (FNP)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:GARRETT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 HIGHWAY 468
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-9058
Mailing Address - Country:US
Mailing Address - Phone:601-824-0988
Mailing Address - Fax:601-824-0987
Practice Address - Street 1:762 HIGHWAY 468
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-9058
Practice Address - Country:US
Practice Address - Phone:601-824-0988
Practice Address - Fax:601-824-0987
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR888688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily