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General NPI Number Information
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NPI Number | 1700214426
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Entity Type | Organization
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Legal Business Name | PREMIER WOMEN'S HEALTH, PLLC
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Dates
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Enumeration Date | 10/15/2013
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 14231 SEAWAY RD #3004
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City | GULFPORT
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State | MS
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Zip | 39503-4628
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Country | US
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Telephone | 228-206-1905
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Fax | 228-206-1917
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Provider Business Mailing Address
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Address Line | PO BOX 7353
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City | GULFPORT
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State | MS
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Zip | 39506-7353
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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 | PRACTICE MANAGER
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Name | SHELLEY PRINGLE
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Credential |
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Telephone | 228-206-1905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 13792
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 18054
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License Number State | MS
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