MEDICARE: BROOKE NITZ PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		MS

General Provider Information

NPI Number	:	1366373011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE NITZ PA-C

Provider Business Mailing Address
First Line	:	102 E HOSPITAL DR
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-1310
Country	:	US
Telephone Number	:	601-475-9968
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 TOMMY MUNRO DR STE A
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39532-2100
Country	:	US
Telephone Number	:	228-335-7863
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ BROOKE NITZ PA-C” Practice Location

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