Mississippi CNA Exam 2026: Your Complete Nurse Aide Certification Guide
The Mississippi Certified Nursing Assistant (CNA) exam — officially the Mississippi Nurse Aide Competency Evaluation — is the two-part test every candidate must pass to work as a nurse aide in Mississippi nursing homes, hospitals, assisted living communities, home health agencies, and hospice. Oversight currently sits with the Mississippi State Department of Health (MSDH) Nurse Aide Program, which contracts with D&S Diversified Technologies / Headmaster LLP to deliver testing and maintain the Mississippi Nurse Aide Registry (MSNAR) through the TestMaster Universe (TMU) portal at ms.tmutest.com.
Big 2026 change: Under Mississippi HB 1415 (2025 regular session), effective July 1, 2026, administration of CNA certification transfers from MSDH to the Mississippi Board of Nursing (MSBN). Positions, funds, and the registry move to MSBN. The current D&S/Headmaster testing contract and TMU portal remain active through the transition — your certificate does not lapse because of the transfer.
Mississippi uses the D&S/Headmaster Mississippi Nurse Aide Candidate Handbook — a 70-question written exam in a tight 60-minute time window, plus a 3 or 4-skill clinical evaluation in 30 minutes total. The passing score is 73% on the written and 80% on each skill with every bolded key step performed correctly. Fees run $35 written + $100 skills = $135 total (audio knowledge version is $45 instead of $35).
This guide covers MSDH training rules, the full D&S blueprint, all 18 testable skills, the 4 mandatory first-task options, Mississippi-specific pitfalls, MSNAR rules, renewal and reciprocity (including the $25 reciprocity fee), the July 2026 MSBN transition, and 2026 Mississippi salary data — so you pass on the first try and start earning.
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Mississippi CNA Exam Format at a Glance (2026 — D&S/Headmaster)
| Component | Details |
|---|---|
| Regulatory Body (through June 30, 2026) | Mississippi State Department of Health (MSDH) — Nurse Aide Program |
| Regulatory Body (from July 1, 2026) | Mississippi Board of Nursing (MSBN) — per HB 1415 (2025) |
| Testing Vendor | D&S Diversified Technologies / Headmaster LLP |
| Scheduling Portal | TestMaster Universe (TMU) — ms.tmutest.com |
| Knowledge Exam | 70 multiple-choice questions (all scored) |
| Knowledge Time Limit | 60 minutes (1 hour) |
| Audio (Oral) Option | Same 70 questions read aloud through headphones — +$10 fee |
| Skills Exam | 3 or 4 randomly assigned tasks (1 mandatory + 2–3 random from 18) |
| Skills Time Limit | 30 minutes total (15-minute warning given) |
| Passing — Knowledge | 73% |
| Passing — Skills | 80% on each task AND every bolded key step performed correctly |
| Knowledge Fee | $35 ($45 for audio version) |
| Skills Fee | $100 |
| Total Combined Fee | $135 |
| Reciprocity Fee | $25 |
| Registry Renewal | Every 24 months, free (employment verification only) |
| Attempts Allowed | 3 per portion within 24 months of training |
| Arrival Window | 20–30 minutes before scheduled start (late = no-show, forfeit fee) |
Candidates who want the questions read aloud can select the Audio Knowledge Exam ($45) — the same 70 questions are read through headphones while you also see them on screen. Mississippi's handbook includes a short reading-comprehension self-assessment — miss more than 3 of those questions and you should take the audio version.
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Mississippi Training Requirements: 75 Hours, 16 Clinical
Mississippi follows the federal OBRA '87 floor of 75 hours — it does not stack state hours on top like Georgia (85), Florida (120), or California (150). Breakdown per MSDH Nurse Aide Training Program (NATP) rules:
- Minimum 75 total hours of MSDH-approved instruction
- At least 16 hours of supervised hands-on clinical experience in a licensed Mississippi long-term care facility
- Pre-clinical orientation covering residents' rights, communication, safety, and infection control before any resident contact
- Training must be directed by a registered nurse (RN) with at least one year of long-term care experience
- Candidates must complete the written and skills evaluation within 24 months of training completion, or the training expires
Many programs exceed the minimum — for example, East Mississippi Community College and Singing River Healthcare Academy run extended programs that add CPR and advanced skills. Programs typically run 3–8 weeks and cost $400–$1,500.
Medicare/Medicaid-certified nursing facilities are federally required to reimburse your exam fees and training costs if they hire you within 12 months of certification. Mississippi chains commonly offering free training with employment commitments include Beverly Healthcare, Magnolia Regional, Diversicare, Baptist Memorial, Golden Living, and Community Eldercare.
MSDH-Approved Program Types
- Community colleges — Hinds, East Mississippi, Mississippi Gulf Coast, Meridian, Northwest, Itawamba, Northeast, Jones, Pearl River, Holmes, Copiah-Lincoln, Southwest
- Career-technical centers under the Mississippi Community College Board
- In-facility NATPs at skilled nursing facilities and hospitals
- Private training schools and American Red Cross chapters
- High school health science programs in approved districts
Mississippi Eligibility Rules
- Minimum age 16 (most programs and employers require 18)
- Pass a Mississippi Department of Public Safety / FBI fingerprint background check — felonies involving abuse, neglect, fraud, or drug diversion are disqualifying under federal law
- Negative two-step TB test, required immunizations, and a physical exam clearance per facility policy
- Valid US government-issued, non-expired, signature-bearing photo ID (driver's license, state ID, US passport, Permanent Resident Card, Tribal ID, or military ID) — first and last name must exactly match your TMU account
- Complete the competency evaluation within 24 months of training completion
Mississippi Challenge / Equivalency Routes
Candidates who can skip or shorten training and go straight to the competency evaluation:
- Nursing students (RN or LPN) who have completed a fundamentals-of-nursing course — submit transcripts demonstrating coursework.
- Military medics and corpsmen — submit DD-214 showing medical MOS (army 68W, navy HM, air force 4N0X1); D&S/MSDH reviews equivalency case by case.
- Out-of-state CNAs with an expired registry listing whose OBRA training is verifiable — handled under reciprocity rather than challenge.
Challenge candidates still pay the $35 written + $100 skills fees and must meet the same passing standards as traditional candidates.
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Our question bank mirrors the D&S/Headmaster Mississippi blueprint — all 12 subject areas, the exact question counts, full explanations, and AI tutor walkthroughs on every wrong answer.
Mississippi CNA Knowledge Exam: 70 Questions, 60 Minutes, 73% to Pass
The written exam has 70 multiple-choice questions — all 70 are scored — with a 60-minute time limit. You are alerted when 15 minutes remain. You need 73% or better to pass (approximately 52 of 70 correct). Calculators are not allowed. The content blueprint is fixed in the handbook and comes directly from the Mississippi State Department of Health approved test plan:
Knowledge Exam Subject Areas (Exact Question Counts)
| Subject Area | # Questions | Subject Area | # Questions |
|---|---|---|---|
| Basic Nursing Skills | 11 | Infection Control | 10 |
| Safety | 9 | Communication | 6 |
| Personal Care | 5 | Resident Rights | 5 |
| Role and Responsibility | 5 | Disease Process | 5 |
| Data Collection | 4 | Mental Health | 4 |
| Aging Process and Restorative Care | 3 | Care Impaired | 3 |
Total: 70 questions. Basic Nursing Skills (11), Infection Control (10), and Safety (9) together make up 43% of the test — that is where most candidates win or lose the written portion.
High-Yield Topics for Mississippi Candidates
- Hand hygiene timing — hand sanitizer covering all surfaces, rubbed until completely dry; soap and water when visibly soiled and at the end of mandatory first tasks
- PPE order — donning: gown → mask → goggles → gloves; doffing: gloves → goggles → gown → mask
- Vital sign normal ranges — BP 90/60–120/80, pulse 60–100, respirations 12–20, oral temp 97.6–99.6°F
- Residents' rights under OBRA — privacy, refusal of care, grievance, personal belongings, freedom from abuse, confidentiality
- Dementia care — validation therapy, redirection, avoiding argument, consistent caregivers, simple one-step directions
- Safe transfer mechanics — lift with legs, keep load close, avoid twisting, gait/transfer belt at the waist
- Abuse and neglect reporting — immediate report to charge nurse AND to the state registry investigators
- Scope of practice — CNAs in Mississippi do NOT administer medications, do sterile dressing changes, cut nails on diabetic residents, or perform IV care
Handbook vocabulary list: The D&S handbook publishes a two-page alphabetical vocabulary list (abdominal thrust → verbal communication). If a term in a question is unfamiliar, it is almost certainly on that list — memorize it.
Free Mississippi CNA Practice Questions
Our bank weights questions exactly like the Mississippi subject-area table above — 11 Basic Nursing, 10 Infection Control, 9 Safety, and the rest — so your practice mock looks like the real test.
Mississippi CNA Skills Test: 3–4 Tasks in 30 Minutes
You will perform 3 or 4 skill tasks in 30 minutes total. The TMU algorithm selects 1 mandatory first task (always built around hand washing with soap and water) plus 2 or 3 random tasks from the Mississippi skill list. You must score at least 80% on each task AND perform every bolded key step correctly — missing a single key step fails that skill regardless of overall percentage.
The 4 Mandatory First-Task Options (One Will Be Assigned)
Every Mississippi skills test begins with one of these tasks, which has hand washing with soap and running water embedded at the end:
- Assist Resident with the Use of a Bedpan, Measure and Record Urine Output, and Hand Washing
- Catheter Care for a Female Resident and Hand Washing (performed on a manikin)
- Donn PPE (Gown and Gloves), Empty a Urinary Drainage Bag, Measure and Record Urine Output, Remove PPE, and Hand Washing
- Perineal Care for a Female and Hand Washing (performed on a manikin)
The Full Mississippi Skill Tasks Listing (18 Tasks)
Your 2–3 random tasks come from this list:
- Apply a Knee-High Anti-Embolic (Elastic) Stocking to One Leg
- Assist Resident to Ambulate Using a Gait Belt
- Assist Resident with the Use of a Bedpan, Measure and Record Urine Output, and Hand Washing (mandatory option)
- Catheter Care for a Female Resident and Hand Washing (mandatory option, manikin)
- Denture Care — Clean Upper or Lower Denture
- Donn PPE (Gown and Gloves), Empty a Urinary Drainage Bag, Measure and Record Urine Output, Remove PPE, and Hand Washing (mandatory option)
- Dress a Resident with an Affected (Weak) Side
- Feed a Dependent Resident
- Foot Care for One Foot
- Modified Bed Bath — Face and One Arm, Hand and Underarm
- Mouth Care — Brush Resident's Teeth
- Passive Range of Motion for One Hip and One Knee
- Passive Range of Motion for One Shoulder
- Perineal Care for a Female and Hand Washing (mandatory option, manikin)
- Position Resident in Bed on Their Side
- Transfer Resident from Their Bed to a Wheelchair Using a Gait Belt
- Vital Signs: Count and Record Resident's Radial Pulse and Respirations
- Vital Signs: Take and Record Resident's Manual Blood Pressure
Critical Step Rules
- Steps are not order-dependent unless the word BEFORE or AFTER is used in the step
- Steps must actually be demonstrated — simulated or verbalized-only steps do NOT count
- BP reading must be within 8 mmHg of the RN Test Observer's reading (both systolic and diastolic)
- Catheter care and perineal care are performed on a manikin; the other tasks use a live resident actor
- You may correct any step during your allotted 30 minutes — tell the observer you want to make a correction, then re-demonstrate the step(s)
- At 15 minutes elapsed, the RN Test Observer will alert you that 15 minutes remain
Mississippi Skills Demo Strategy
- Perform hand hygiene with hand sanitizer at the start of every non-mandatory task (cover all surfaces, rub until completely dry) — soap and water is embedded only at the end of the 4 mandatory first tasks
- Count radial pulse and respirations per the handbook's exact steps
- For manual BP: apply appropriate-size cuff, arrows over brachial artery, inflate cuff to 160–180 mmHg, slowly release air, record within 8 mmHg of the observer
- Dress the weak arm first; undress the strong arm first — wrong order is an automatic fail
- Apply knee-high stocking inside-out to the heel, heel in the heel pocket, smooth and wrinkle-free
- Lock bed AND wheelchair brakes before any transfer
- Maintain respectful, courteous interpersonal interactions — this is literally a scored step on most tasks
- Place the call light within reach before you tell the observer you are finished with a task
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Our skills module breaks each task into the exact numbered steps in the D&S handbook with bolded key steps flagged in red, plus the most common Mississippi failure points called out explicitly.
Mississippi CNA Exam Fees (2026)
| Exam Type | Fee |
|---|---|
| Written / Knowledge Test | $35 |
| Audio Version of Knowledge Exam | $45 (+$10 over standard) |
| Skills Test | $100 |
| Combined Written + Skills | $135 |
| Reciprocity / Endorsement Application | $25 |
| Registry Renewal (employment-based) | Free |
Fees are paid directly to D&S Diversified / Headmaster through the TMU candidate portal at ms.tmutest.com. Visa or MasterCard credit/debit card is required for self-pay. Mailed documentation goes to D&SDT-HEADMASTER, PO Box 418, Findlay, OH 45839. Mississippi long-term care facility employers commonly cover the full $135 — federal rules require Medicare/Medicaid-certified facilities to reimburse new hires within 12 months of certification.
Retake Fees and Attempts
- Failed written only: retake for $35 (or $45 audio)
- Failed skills only: retake for $100
- Failed both: retake both for $135
- You have 3 total attempts per portion within 24 months of training completion
- After 3 failures or exceeding the 24-month window, you must repeat the full 75-hour NATP before retesting
- Lapsed nurse aides (no 8 qualifying hours in 24 months) get only one attempt per portion — fail once and you must retrain
Mississippi-Specific Pitfalls That Fail Candidates
After reviewing the D&S/Headmaster Mississippi handbook directives, these are the most common reasons MS candidates fail:
- Using hand sanitizer on a mandatory first task that requires soap and water — automatic key-step fail
- Skipping the call light at the end of any task — automatic key-step miss
- Transferring without locking bed AND wheelchair brakes — immediate safety fail
- Wrong PPE donning/doffing order on the donning/PPE mandatory task
- BP reading more than 8 mmHg off the observer's reading (systolic or diastolic) — automatic fail on the BP task
- Dressing the strong arm first — always dress the weak/affected side first; undress the strong side first
- Simulating or only verbalizing a step — every step must be physically demonstrated to count
- Blowing the 30-minute total clock — budget roughly 7–10 minutes per task; do not over-narrate
- Showing up late — Mississippi testing sites require check-in 20–30 minutes before the scheduled start; arriving after the start time is a no-show and your fee is forfeit
- Wrong scrubs or closed-toe shoe violation — you will not be admitted without scrubs and appropriate shoes
- Name on ID not exactly matching TMU — first and last name must match exactly, or you are a no-show
- Missing the 24-month testing window after training — you must retrain fully if you exceed it
Mississippi CNA Test-Day Checklist
Bring to the Test
- Non-expired, signed, US government-issued photo ID — driver's license, state ID, US passport, Permanent Resident Card, Tribal ID, or military ID (first/last name must exactly match your TMU account)
- TMU confirmation letter / scheduling confirmation
- Standard watch with a second hand for counting vitals — smart watches and fitness monitors are NOT allowed
- Scrubs and appropriate closed-toe, non-slip shoes — required for admission
- Optional in the waiting area only: jacket, snack, drink, or study materials
- Foreign-language paper translation dictionary (if needed) — must have no writing or notes; show the observer at check-in
Do NOT Bring into the Testing Room
- Cell phone, smart watch, fitness monitor, Bluetooth device, electronic recording device
- Water bottle, purse, briefcase, large bag, extra books, study materials, or papers
- Calculator (not allowed during the knowledge test)
- Electronic translators or electronic dictionaries
- Hats, hoodies, or sunglasses
Morning-Of Tips
- Eat a protein-rich breakfast — skills tasks are physical and run back-to-back
- Hair pulled back; fingernails trimmed short and unpolished
- Wear clean scrubs (no shorts, sleeveless tops, or open-toe shoes)
- Arrive 20–30 minutes early — if start time is 8:00 AM, be on site by 7:30–7:40 AM at the latest
- Plan to be on site for up to 5 hours if taking both components the same day
The Mississippi Nurse Aide Registry (MSNAR)
Passing both portions adds you to the Mississippi Nurse Aide Registry (MSNAR), currently maintained by D&SDT-Headmaster under contract with MSDH — and transitioning to the Mississippi Board of Nursing on July 1, 2026 under HB 1415 (2025). Employers are federally required to verify registry status before hiring any CNA. Your listing goes live within a few business days of passing.
Verifying Your Registry Status
- MSDH renew-or-verify page — msdh.ms.gov/page/30,0,82,353.html
- D&S Mississippi candidate portal — hdmaster.com
- TMU self-service — ms.tmutest.com
- D&SDT-HEADMASTER support — 888-401-0462 or mississippi@hdmaster.com (7 AM – 7 PM CST, Mon–Fri)
- Listings include name, certificate number, expiration date, and any findings of abuse, neglect, or misappropriation of property
- Report name/address changes via the TMU portal with supporting documentation
Renewal (Every 24 Months — Free, Employment-Based)
Mississippi uses employment-based renewal — no classroom continuing education is required.
- You must have performed at least 8 consecutive paid hours of nursing or nursing-related services as a nurse aide in a Mississippi nursing home, hospital, hospice, home health agency, or ICF/MR facility during the previous 24 months
- Employment agencies cannot verify — list the long-term care facility where you were placed, not the agency
- Private-duty, doctor's office, laboratory, personal care home assisted living, and residential living aide roles do NOT qualify
- Sign in to TMU, enter your work hours and employer, and the employer contact receives an email verification link — once verified, your eligibility is extended 24 months
- Expect a reminder 60 days before your expiration date
- Grace period: 30 days after expiration to renew — miss that window and you must retest (lapsed aides get only one attempt per portion)
Reciprocity / Endorsement (Out-of-State CNAs Moving to Mississippi)
Mississippi accepts reciprocity from most states for CNAs current and in good standing on any other OBRA-compliant state registry.
Requirements:
- Active, unexpired listing on another state's nurse aide registry
- No findings of abuse, neglect, or misappropriation of property
- Training that met federal OBRA '87 standards (75 hours, 16 clinical)
- 8 hours of paid nurse aide work documented (W-2 or pay stub acceptable)
- Mississippi fingerprint background check clearance
Process:
- Sign in to TMU at ms.tmutest.com → APPLICATIONS → CNA Reciprocity Form
- Upload photo ID, home-state registry verification, and work-experience documentation
- Pay the $25 processing fee by credit/debit card
- Allow 2–4 weeks for D&S/MSDH to review and list you on MSNAR
If your home-state training fell below 75 hours or lacked the required 16 clinical hours, D&S may require a bridge course and the Mississippi skills evaluation — common when transferring from states with abbreviated programs.
July 1, 2026: The MSDH → MSBN Transition Explained
Mississippi HB 1415 (2025 regular session) moves CNA certification out of MSDH and into the Mississippi Board of Nursing (MSBN) effective July 1, 2026. What that means for candidates:
- Through June 30, 2026: MSDH is the regulator; MSNAR is administered by D&S under MSDH contract; applications continue through TMU
- On July 1, 2026: MSDH staff involved in CNA certification transfer to MSBN, and remaining CNA program funds move to a dedicated MSBN special fund
- Your certificate remains valid — no re-testing is triggered by the transfer
- Testing contract: The D&S/Headmaster testing contract and the TMU portal are expected to continue without interruption; watch msbn.ms.gov for post-transition guidance
- Reciprocity and renewal applications submitted before and after July 1 will be processed by whichever body holds the file — plan for a short processing delay around the transition date
If you are scheduling the exam close to July 1, 2026, file your TMU application at least 30 days early to avoid any switchover backlog.
Mississippi CNA Study Timeline (6-Week Plan)
| Week | Focus | Hours | Activities |
|---|---|---|---|
| 1 | Foundations | 8–10 | Role and Responsibility, Communication, Resident Rights, Data Collection |
| 2 | Infection & Safety | 8–10 | Infection Control (10 Q), Safety (9 Q) — 27% of the written test |
| 3 | Basic Nursing + Personal Care | 10–12 | Basic Nursing Skills (11 Q), Personal Care (5 Q), Disease Process (5 Q) |
| 4 | Skills Tasks — Mandatory First Tasks | 10–12 | Bedpan + output, catheter care, PPE + urinary bag, peri-care |
| 5 | Skills Tasks — Random Pool + Mental Health | 10–12 | PROM, BP, pulse/respirations, transfers, feeding, ADLs, dementia care |
| 6 | Full Review + Timed Mocks | 10–15 | Timed 70-question / 60-minute mocks, demo 3-task and 4-task skills sets |
Total: 50–70 hours of focused study on top of your 75-hour MSDH-approved NATP.
Mississippi CNA Salary and Career Outlook
Mississippi CNA Pay in 2026
| Location / Source | Hourly | Annual |
|---|---|---|
| Mississippi statewide average (ZipRecruiter, 2026) | ~$19.00 | ~$39,525 |
| Mississippi CNA (Glassdoor, 2026) | ~$19.00 | ~$39,142 |
| Hospital CNA (ZipRecruiter, 2026) | ~$21.96 | ~$45,680 |
| Traveling CNA (ZipRecruiter, 2026) | ~$20.31 | ~$42,245 |
| Mississippi top end | ~$23.00 | ~$48,048 |
| Mississippi bottom end | ~$15.00 | ~$32,110 |
Mississippi historically ranks among the lower-paying CNA states nationally, and Glassdoor shows MS CNAs earning ~10% below the national average. Still, 2026 hospital and travel-contract work pushes top earners above $23/hour. Jackson, the Gulf Coast, and the Tupelo hospital corridor offer the strongest pay. Night and weekend differentials add $2–$5/hour.
Where Mississippi CNAs Work
- Skilled nursing facilities (SNFs) — largest single employer statewide
- Hospitals — University of Mississippi Medical Center (UMMC, Jackson), Baptist Memorial (DeSoto, Oxford, Golden Triangle), Forrest General (Hattiesburg), Singing River (Pascagoula/Ocean Springs), Memorial Hospital at Gulfport, North Mississippi Medical Center (Tupelo), Merit Health
- Assisted living and memory care communities
- Home health agencies — Amedisys, Encompass Health, LHC Group, Mississippi Home Care
- Hospice agencies
- Mississippi State Veterans Homes (Collins, Jackson, Kosciusko, Oxford)
- VA medical centers — Jackson (G.V. Sonny Montgomery VAMC), Biloxi
Career Advancement Pathways
| Path | Duration | Next Step |
|---|---|---|
| CNA → LPN | 12–18 months | MS community college LPN programs (Hinds, East MS, MGCCC, Meridian, Jones, Northwest) |
| CNA → ADN (RN) | 2 years | Community college ADN (Hinds, Pearl River, Northeast, Itawamba, MGCCC) |
| CNA → BSN (RN) | 4 years | UMMC School of Nursing, Mississippi College, USM, Delta State, William Carey |
| CNA → Medication Aide | +40–100 hours | MSDH-recognized medication aide certification (where offered) |
| CNA → Patient Care Tech (PCT) | On-the-job | Hospital PCT role with phlebotomy / EKG add-on training |
Pass the Mississippi CNA Exam with Confidence
Join Mississippi candidates who passed their D&S/Headmaster competency evaluation with our comprehensive, 100% FREE study tools:
- Mississippi-aligned practice questions mirroring the exact 12 subject areas and question weights (11 Basic Nursing, 10 Infection Control, 9 Safety, …)
- All 18 skill tasks with step-by-step bolded key-step checklists, including all 4 mandatory first-task options
- Timed mock exams matching the real 70-question, 60-minute format — including a 73%-threshold scoring engine
- AI tutor that explains wrong answers and drills weak areas
- Updated for 2026 — reflects the current Mississippi Nurse Aide Candidate Handbook and the July 1, 2026 MSBN transition
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Official Mississippi CNA Resources
- MSDH Nurse Aide Program — state regulatory body through June 30, 2026
- MSDH Renew or Verify — registry status, renewal, verification
- Mississippi Board of Nursing (MSBN) — regulator from July 1, 2026 per HB 1415 (2025)
- D&S/Headmaster Mississippi Test-Taker Portal — handbook, scheduling, forms
- Mississippi TMU Candidate Portal — applications, payments, renewals, reciprocity
- D&SDT-HEADMASTER Mississippi support — 888-401-0462 | mississippi@hdmaster.com (7 AM – 7 PM CST, Mon–Fri)
- Mailing address for paper applications and documentation: D&SDT-HEADMASTER, PO Box 418, Findlay, OH 45839
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