Individual
STEPHANIE NIX LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
180B DEBUYS RD STE 203, BILOXI, MS 39531
(228) 273-4096
(228) 594-1765
Mailing address
PO BOX 4594, BILOXI, MS 39535-4594
(228) 273-4096
(228) 594-1765
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06935861
—
MS
Enumeration date
03/01/2016
Last updated
06/11/2019
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