PASS ROAD ELEMENTARY NPI 1154543528

NPI Information

NPI: 1154543528
Provider Name: PASS ROAD ELEMENTARY

Other Name: HEALTHY KIDS CLINIC AT PASS ROAD ELEMENTARY

Classification: Registered Nurse - 163WS0200X
Entity Type: Organization

Specialization: School

Address:
37 PASS ROAD
GULFPORT, MS
ZIP 39507
Phone: (228) 865-4659
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PASS ROAD ELEMENTARY is a school registered nurse in Gulfport, MS. PASS ROAD ELEMENTARY NPI is 1154543528. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Healthy Kids Clinic At Pass Road Elementary.

The provider's business location address is:

37 PASS ROAD
GULFPORT, MS
ZIP 39507
Phone: (228) 865-4659

The provider's authorized official is Stacey Waldrop .
The authorized official title is School Nurse and has the following contact phone number (228) 865-4659.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WS0200X	Registered Nurse	School	R772068	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00836002	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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