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General NPI Number Information
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NPI Number | 1255610598
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Entity Type | Individual
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Provider Name | ERICA ENGER CROSS PA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 5935 WASHINGTON AVE STE A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2642
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Country | US
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Telephone | 228-215-0669
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Fax | 228-215-0669
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Provider Business Mailing Address
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Address Line | 6008 SHORE DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2269
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Country | US
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Telephone | 228-215-0669
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Fax | 228-215-0669
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00189
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License Number State | MS
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