Healthcare Provider Details

I. General information

NPI: 1699385237
Provider Name (Legal Business Name): DAYNA CUPPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAYNA BEASLEY

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 13TH ST.
GULFPORT MS
39501
US

IV. Provider business mailing address

PO BOX 1810
GULFPORT MS
39502
US

V. Phone/Fax

Practice location:
  • Phone: 228-865-3281
  • Fax: 228-867-5117
Mailing address:
  • Phone: 228-575-1194
  • Fax: 228-575-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number39654
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901855
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: