Individual
MRS. SUSAN KNOWLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FPMHNP
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R865348
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018213
—
MS
05
—
01520708
—
MS
Enumeration date
07/18/2006
Last updated
04/16/2014
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