Individual
KASSIE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
116 MENGE AVE APT A, PASS CHRISTIAN, MS 39571-4738
(228) 586-9565
(228) 864-3333
Mailing address
11295 E. TAYLOR ROAD, GULFPORT, MS 39503-4197
(228) 864-3300
(228) 864-3333
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.200296
LA
363A00000X
Physician Assistant
Primary
PA00128
MS
Other
Enumeration date
11/04/2009
Last updated
10/18/2024
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