Individual
MRS. JENNIFER L JURICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
15476 DEDEAUX RD, GULFPORT, MS 39503-2637
(228) 230-2663
Mailing address
6300 E LAKE BLVD STE 301, VANCLEAVE, MS 39565-6771
(228) 230-2663
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
R872972
MS
363L00000X
Nurse Practitioner
R872972
MS
363LF0000X
Family Nurse Practitioner
Primary
R872972
MS
Other
Enumeration date
02/08/2010
Last updated
04/22/2025
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