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General NPI Number Information
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NPI Number | 1336309921
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Entity Type | Individual
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Provider Name | NANCY G. BLADSACKER DNP, FNP-BC, CNM
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Gender | Female
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 4502 OLD PASS RD
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City | GULFPORT
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State | MS
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Zip | 39501-2585
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Country | US
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Telephone | 228-863-9977
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Fax | 228-863-9912
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Provider Business Mailing Address
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Address Line | 4502 OLD PASS RD
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City | GULFPORT
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State | MS
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Zip | 39501-2585
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Country | US
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Telephone | 228-863-9977
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Fax | 228-863-9912
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R678341
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | R678341
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License Number State | MS
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