Healthcare Provider Details

I. General information

NPI: 1063201804
Provider Name (Legal Business Name): VANESSA STOROZUK APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5003 HARDY ST STE 200
HATTIESBURG MS
39402-1331
US

IV. Provider business mailing address

5003 HARDY ST STE 200
HATTIESBURG MS
39402-1331
US

V. Phone/Fax

Practice location:
  • Phone: 601-261-5700
  • Fax: 601-261-5777
Mailing address:
  • Phone: 601-261-5700
  • Fax: 601-261-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907240
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: