Healthcare Provider Details

I. General information

NPI: 1114397536
Provider Name (Legal Business Name): SUSAN P MUZSLAY RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 09/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 BIENVILLE BLVD
OCEAN SPRINGS MS
39564-5803
US

IV. Provider business mailing address

3616 HOSPITAL ST SUITE A
PASCAGOULA MS
39581-4117
US

V. Phone/Fax

Practice location:
  • Phone: 228-872-6291
  • Fax: 228-872-7627
Mailing address:
  • Phone: 228-769-1035
  • Fax: 228-769-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberD0224
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: