Search › Mississippi › 101Y00000X
Herman Island
NPI 1700701547 · on the registry since 2026 · sole proprietor
Practice
- Address
- 1017 Abbay St Apt C2
Tunica, MS 38676 - Phone
- (662) 613-9199
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-08-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi