# PASS ROAD ELEMENTARY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Healthy Kids Clinic at Pass Road Elementary
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154543528
- **Authorized official:** MS. STACEY WALDROP RN, NCSN (SCHOOL NURSE)
- **Authorized official phone:** (228) 865-4659

## Contact information

- **Practice address:** 37 PASS ROAD, GULFPORT, MS 39507
- **Practice address phone:** (228) 865-4659
- **Mailing address:** 37 PASS ROAD, GULFPORT, MS 39507
- **Mailing address phone:** (228) 865-4659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WS0200X | School Registered Nurse | R772068 | MS | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020