Memorial Hospital at Gulfport

Organization Active NPI Family Nurse Practitioner · Gulfport, MS

NPI 1124392329 · NPPES record last updated Mar 6, 2012

Key facts

NPI
1124392329
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
R878630 (MS)
Legal business name
MEMORIAL HOSPITAL AT GULFPORT
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 867-4000
NPI assigned
Mar 6, 2012
Organization subpart
No

Authorized official

Name
Kent Nicaud
Title
Office Manager/Administrator
Phone
(228) 867-4000

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Memorial Hospital at Gulfport (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X R878630 MS Yes

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

PO Box 555
Biloxi, MS 39533-0555

Other providers in Gulfport, MS

All providers in Gulfport, MS · Family Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.