Individual
DEBRA B BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
14116 CUSTOMS BLVD, GULFPORT, MS 39503-5164
(833) 362-6703
Mailing address
2918 LOUIS SESSIONS ST, LAKE VILLAGE, AR 71653-6049
(870) 265-5343
(870) 265-5686
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A004596
AR
363L00000X
Nurse Practitioner
Primary
R852798
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125904
—
MS
Enumeration date
10/20/2006
Last updated
12/18/2019
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