Individual
MAUREEN STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
33 39TH STREET, GULFPORT, MS 39507
(228) 861-0176
(228) 831-4495
Mailing address
33 39TH STREET, GULFPORT, MS 39507
(228) 861-0176
(228) 831-4495
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R564265
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08634798
—
MS
Enumeration date
01/12/2007
Last updated
06/25/2009
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