Individual
MRS. KATRINA BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1391 BROAD AVE, GULFPORT, MS 39501-2419
(228) 863-8868
(228) 863-8132
Mailing address
650 S GRIFFIN ST, DALLAS, TX 75202-5005
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
904601
MS
Other
Enumeration date
03/30/2021
Last updated
08/04/2021
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