Individual
MS. MAI THI TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 44TH AVE, GULFPORT, MS 39501-2554
(228) 575-2780
Mailing address
1404 44TH AVE, GULFPORT, MS 39501-2554
(228) 575-2870
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903187
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
903187
MS BOARD OF NURSING
MS
01
—
F01191804
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
02/26/2019
Last updated
10/01/2019
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