Individual
MS. FAYE CENTENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
1102 45TH AVE, GULFPORT, MS 39501-2504
(228) 863-1036
Mailing address
1116 32ND AVE, GULFPORT, MS 39501-1854
(228) 300-7116
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
15659
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
902222
MS
Other
Enumeration date
10/07/2005
Last updated
01/08/2018
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