Individual
MRS. STELLA JEANINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP, RDN
Contact information
Practice address
1199 OCEAN SPRINGS RD, OCEAN SPRINGS, MS 39564-3421
(228) 865-1330
(228) 865-1331
Mailing address
370 COURTHOUSE RD STE 106, GULFPORT, MS 39507-1889
(228) 865-1330
(228) 865-1331
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2692
AL
363LF0000X
Family Nurse Practitioner
1-110662
AL
363LF0000X
Family Nurse Practitioner
Primary
903220
MS
363LF0000X
Family Nurse Practitioner
F1210163
AL
Other
Enumeration date
02/08/2011
Last updated
08/04/2022
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