Individual
SUSAN M SICOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
101 WEEMS ST, PURVIS, MS 39475-4062
(601) 794-2224
(601) 794-6392
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R142560
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126500
—
MS
01
—
5726300
CIGNA
MS
01
—
P00844126
RAILROAD MEDICARE
MS
Enumeration date
09/27/2006
Last updated
02/05/2015
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