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Individual

CARRICKA D THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2300 24TH AVE, GULFPORT, MS 39501
(228) 343-3606
(866) 659-9359
Mailing address
718 BRIARWOOD DR, LONG BEACH, MS 39560-3811
(228) 326-9951
(866) 659-9359

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
229146
LA
363LF0000X
Family Nurse Practitioner
R864120
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09032325
MS
Enumeration date
10/22/2010
Last updated
07/25/2023
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