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General NPI Number Information
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NPI Number | 1992800916
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Entity Type | Individual
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Provider Name | RUTH SHIRLEY SESERA NP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 5912 OLD MOBILE HIGHWAY
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City | PASCAGOULA
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State | MS
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Zip | 39581
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Country | US
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Telephone | 228-762-4642
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Fax | 228-207-3087
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Provider Business Mailing Address
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Address Line | 10052 PLANTATION DR
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City | DAPHNE
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State | AL
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Zip | 36526-8574
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Country | US
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Telephone | 251-621-8485
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-090086
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R879202
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License Number State | MS
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