Individual
MRS. ASHLEY NICOLE DEAN-REAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4502 OLD PASS RD, GULFPORT, MS 39501
(228) 863-9977
(228) 863-9912
Mailing address
4502 OLD PASS RD, GULFPORT, MS 39501
(228) 863-9977
(228) 863-9912
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901636
MS
363LF0000X
Family Nurse Practitioner
R901636
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01700380
—
MS
Enumeration date
09/14/2016
Last updated
07/21/2022
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