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Organization
MARSHA VYVERBERG, NP, PLLC
Active
Organization
MARSHA VYVERBERG, NP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA VYVERBERG NP (OWNER)
(228) 331-3310
Entity
Organization
Contact information
Practice address
8990 LORRAINE RD, GULFPORT, MS 39503-4176
(228) 331-3310
(228) 284-1608
Mailing address
8990 LORRAINE RD, GULFPORT, MS 39503-4176
(228) 331-3310
(228) 284-1608
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R889555
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08985581
—
MS
01
—
320454YKC0
MEDICARE PTAN
MS
Enumeration date
04/20/2016
Last updated
04/20/2016
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