Individual
SHAWANNA BUMPERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16145 ORANGE GROVE RD STE A1, GULFPORT, MS 39503-2966
(228) 547-9349
(228) 731-3182
Mailing address
16145 ORANGE GROVE RD STE A1, GULFPORT, MS 39503-2966
(228) 547-9349
(228) 731-3182
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
800884908
MS
Other
Enumeration date
02/22/2024
Last updated
02/22/2024
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