Individual
MRS. VIRGINIA LORAIN QUANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP, FNP, DNP
Contact information
Practice address
1202 BROAD AVE, GULFPORT, MS 39501-2426
(228) 864-7631
Mailing address
PO BOX 3118, GULFPORT, MS 39505-3118
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R857963
MS
Other
Enumeration date
06/28/2007
Last updated
03/11/2013
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