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Individual

SUZANNE STAATS-PUFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP, PMHNP

Contact information

Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R741154
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00110703
MS
Enumeration date
03/15/2006
Last updated
08/29/2019
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