Individual
ELIZA MACRERY KNUDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
15012 LEMOYNE BLVD, BILOXI, MS 39532-5205
(228) 392-9174
Mailing address
17186 EXCALIBUR CIR, GULFPORT, MS 39503-3676
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904697
MS
Other
Enumeration date
06/14/2021
Last updated
07/19/2021
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