Individual
MS. MARY PENLAND SPEYRER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
9344 THREE RIVERS RD, GULFPORT, MS 39503-4268
(228) 865-9898
(228) 863-5616
Mailing address
PO BOX 2563, GULFPORT, MS 39505-2563
(228) 865-9898
(228) 863-5616
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
901778
MS
363LA2100X
Acute Care Nurse Practitioner
AP03039
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01200718
—
MS
05
—
1533173
—
LA
01
—
232781
WELLCARE
LA
01
—
5000023389
RAILROAD MEDICARE
LA
01
—
558986YNL6
MEDICARE
MS
Enumeration date
01/16/2006
Last updated
07/21/2022
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