Organization
MEMORIAL HOSPITAL AT GULFPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT NICAUD (OFFICE MANAGER/ADMINISTRATOR)
(228) 867-4000
Entity
Organization
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 867-4000
Mailing address
PO BOX 555, BILOXI, MS 39533-0555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R878630
MS
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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