Individual
TONI L LADNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1911 MISSION 66 STE B, VICKSBURG, MS 39180-3762
(601) 665-4162
(855) 830-3484
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
R850484
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
850484
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018213
—
MS
05
—
01583061
—
MS
Enumeration date
03/22/2012
Last updated
03/30/2023
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