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General NPI Number Information
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NPI Number | 1144183740
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Entity Type | Individual
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Provider Name | CAMERON PENNY
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Gender | Male
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3603 BIENVILLE BLVD STE 102
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5736
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Country | US
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Telephone | 228-818-9620
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Fax |
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Provider Business Mailing Address
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Address Line | 13419 DURHAM LN
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City | BILOXI
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State | MS
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Zip | 39532-1801
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Country | US
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Telephone | 228-818-9620
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Fax |
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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 | 1-182215
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License Number State | AL
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