Stephanie Eatman, LMSW

Individual provider Active NPI Social Worker · Purvis, MS

NPI 1477560092 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1477560092
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
M6521 (MS)
Practice address
805 Hwy 589
Purvis, MS 39475
Phone
(601) 794-6549
Fax
(601) 584-4053
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
M6521MSMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M6521 MS Yes

Addresses

Primary practice location

805 Hwy 589
Purvis, MS 39475

Mailing address

PO Box 489
Purvis, MS 39475-0489
Phone (601) 794-6549

Other providers in Purvis, MS

All providers in Purvis, MS · Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.