Individual
LISSA KELLY BABER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
1340 BROAD AVE, GULFPORT, MS 39501-2404
(228) 867-5012
Mailing address
5 OAK ALLEY LN, LONG BEACH, MS 39560-8000
(601) 433-0575
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
903259
MS
Other
Enumeration date
04/18/2019
Last updated
06/30/2019
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