Individual
MYESHA MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 822-6132
Mailing address
17248 EXCALIBUR CIR, GULFPORT, MS 39503-3864
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906943
MS
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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