Individual
SALLY M PROFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
15190 COMMUNITY RD STE 260, GULFPORT, MS 39503-3471
(228) 575-7290
(228) 831-8189
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R878145
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08234830
—
MS
Enumeration date
01/19/2012
Last updated
02/07/2026
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