Individual
MICHELLE M BLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868
Mailing address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R866309
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R866309
LICENSE
MS
Enumeration date
06/25/2008
Last updated
08/07/2023
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