Organization
PASS ROAD ELEMENTARY
Active
Other names
Healthy Kids Clinic at Pass Road Elementary
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACEY WALDROP RN, NCSN (SCHOOL NURSE)
(228) 865-4659
Entity
Organization
Contact information
Practice address
37 PASS ROAD, GULFPORT, MS 39507
(228) 865-4659
Mailing address
37 PASS ROAD, GULFPORT, MS 39507
(228) 865-4659
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R772068
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00836002
—
MS
Enumeration date
05/03/2007
Last updated
08/22/2020
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