Ms Detra La'quel Humphries, RN - Registered Nurse in Jackson, MS

Ms Detra La'quel Humphries, RN is a Registered Nurse - Addiction (substance Use Disorder) based in Jackson, Mississippi. Ms Detra La'quel Humphries is licensed to practice in Mississippi (license number R865122) and her current practice location is 1935 Lakeland Dr Ste 900, Jackson, Mississippi. She can be reached at her office (for appointments etc.) via phone at (601) 718-2487.

NPI number for Ms Detra La'quel Humphries is 1033805569 and her current mailing address is 1935 Lakeland Dr Ste 900, Jackson, Mississippi. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1033805569.

Contact Information

Ms Detra La'quel Humphries, RN
1935 Lakeland Dr Ste 900,
Jackson, MS 39216-5028
(601) 718-2487
Not Available



Provider's Profile

Full NameMs Detra La'quel Humphries
GenderFemale
SpecialityRegistered Nurse - Addiction (substance Use Disorder)
Location1935 Lakeland Dr Ste 900, Jackson, Mississippi
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1033805569
  • Provider Enumeration Date: 04/17/2023
  • Last Update Date: 04/17/2023

Medical Identifiers

Medical identifiers for Ms Detra La'quel Humphries such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033805569NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WA0400XRegistered Nurse - Addiction (substance Use Disorder) R865122 (Mississippi)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Detra La'quel Humphries is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Detra La'quel Humphries, RN
1935 Lakeland Dr Ste 900,
Jackson, MS 39216-5028

Ph: (601) 718-2487
Ms Detra La'quel Humphries, RN
1935 Lakeland Dr Ste 900,
Jackson, MS 39216-5028

Ph: (601) 718-2487

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› Verified 5 days ago


Registered Nurse Nurses in Jackson, MS

Melissa Allene Graig, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1500 E Woodrow Wilson Ave, Jackson, MS 39216
Phone: 601-362-4471    
Haden Davis,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1225 N State St, Jackson, MS 39202
Phone: 601-968-1044    
Ms. Brenda E Day, CLINICAL NURSE SPECI
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1500 Woodrow Wilson Blvd East, Va Medical Center, Jackson, MS 39216
Phone: 601-362-4471    Fax: 601-364-1298
Leigh Allyson Brantley, CRNA
Registered Nurse
Medicare: Accepting Medicare Assignments
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-1000    
Amanda Welch,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1255 E County Line Rd Apt K8, Jackson, MS 39211
Phone: 662-402-9162    
Gareth Bond,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-1000    

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