Healthcare Provider Details

I. General information

NPI: 1235943341
Provider Name (Legal Business Name): TAMMY NICOLE REUS MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 BIENVILLE BLVD STE F1
OCEAN SPRINGS MS
39564-3076
US

IV. Provider business mailing address

2112 BIENVILLE BLVD STE F1
OCEAN SPRINGS MS
39564-3076
US

V. Phone/Fax

Practice location:
  • Phone: 228-818-1850
  • Fax:
Mailing address:
  • Phone: 228-818-1850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number896757
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3-002196
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907291
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: