Individual
TRACY ROSEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
5003 HARDY ST, SUITE 350, HATTIESBURG, MS 39402-1319
(601) 268-9393
(601) 268-9393
Mailing address
6524 U S HIGHWAY 98, HATTIESBURG, MS 39402-8569
(601) 268-9393
(601) 268-9393
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R717789
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118112
—
MS
Enumeration date
12/27/2005
Last updated
10/30/2015
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