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General NPI Number Information
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NPI Number | 1083159099
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Entity Type | Individual
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Provider Name | AMY L PONTIUS NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 15190 COMMUNITY RD STE 300
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City | GULFPORT
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State | MS
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Zip | 39503-3499
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Country | US
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Telephone | 228-819-8586
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Fax | 228-831-3908
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Provider Business Mailing Address
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Address Line | 168 MOBILE INFIRMARY BLVD
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City | MOBILE
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State | AL
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Zip | 36607-3510
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Country | US
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Telephone | 251-433-1895
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Fax | 251-433-1917
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R820497
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 901897
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License Number State | MS
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