Individual
MRS. PRISCILLA M. RENWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4333 15TH ST, SUITE A, GULFPORT, MS 39501-2525
(228) 863-4000
(228) 863-4003
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 863-4000
(228) 863-4003
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R551635
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126456
—
MS
Enumeration date
07/07/2005
Last updated
07/10/2014
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