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Individual

MICHAEL J NECAISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RNFA, CNOR

Contact information

Practice address
4500 13TH ST, GULFPORT, MS 39501-2569
(228) 865-3644
Mailing address
4500 13TH ST, GULFPORT, MS 39501-2569
(228) 865-3644

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
863311
MS
163WR0006X
Registered Nurse First Assistant
Primary
863311
MS

Other

Enumeration date
03/18/2019
Last updated
03/18/2019
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