Individual
DIANE C. JAKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
400 SECURITY SQ, GULFPORT, MS 39507-1932
(228) 865-1330
(228) 865-1331
Mailing address
400 SECURITY SQ, GULFPORT, MS 39507-1932
(228) 865-1330
(228) 865-1331
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R772563
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01282761
—
MS
Enumeration date
08/16/2007
Last updated
04/03/2013
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