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General NPI Number Information
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NPI Number | 1477466688
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Entity Type | Organization
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Legal Business Name | BAY PEDIATRICS LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 828 HIGHWAY 90 STE A
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City | BAY SAINT LOUIS
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State | MS
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Zip | 39520-2721
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Country | US
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Telephone | 228-493-2409
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Fax |
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Provider Business Mailing Address
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Address Line | 5663 HODA RD
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City | KILN
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State | MS
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Zip | 39556-6158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KATHERINE STOCKSTILL
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Credential |
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Telephone | 228-493-2409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State | NULL
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