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Individual

DONALD ALLAN DEARMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
1911 MISSION 66 STE B, VICKSBURG, MS 39180-3762
(601) 665-4162
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
902297
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00026591
MS
Enumeration date
10/12/2017
Last updated
11/18/2021
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