Individual
AMY R DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC, WHNP-BC
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5400
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
857450
MS
363LW0102X
Women's Health Nurse Practitioner
R857450
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00127100
—
MS
Enumeration date
12/15/2010
Last updated
03/25/2025
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