Individual
MRS. STACY N KNUTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0429
Mailing address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00553
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098239
NCCPA
—
Enumeration date
05/28/2010
Last updated
06/18/2021
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