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General NPI Number Information
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NPI Number | 1427289677
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Entity Type | Individual
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Provider Name | LORING JOHN SMITH JR. PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 400 VETERANS AVE BLDG. T-100
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City | BILOXI
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State | MS
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Zip | 39531-2410
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Country | US
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Telephone | 228-523-4784
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Fax | 228-523-5959
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Provider Business Mailing Address
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Address Line | 1641 POPPS FERRY RD STE A3
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City | BILOXI
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State | MS
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Zip | 39532-2226
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Country | US
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Telephone | 228-232-0890
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Fax | 228-232-0891
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R662992
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | R662992
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License Number State | MS
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