Healthcare Provider Details

I. General information

NPI: 1144000522
Provider Name (Legal Business Name): RHYANNEN A MAJO SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6608 SHORE DR
OCEAN SPRINGS MS
39564-2577
US

IV. Provider business mailing address

6608 SHORE DR
OCEAN SPRINGS MS
39564-2577
US

V. Phone/Fax

Practice location:
  • Phone: 228-383-4934
  • Fax:
Mailing address:
  • Phone: 228-383-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number895300
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number902069
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: