Dedeaux, Jillian R

Dedeaux, Jillian R is an individual health care provider with primary practice located at 14247 N Swan Rd , Gulfport MS 39503-8551. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Dedeaux, Jillian R can be contacted via phone (228) 297-6640.

Contact Information

Primary practice address
14247 N Swan Rd Gulfport MS 39503-8551
Phone: (228) 297-6640
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X

Profile Details

NPI number 1710566336
LBN Legal business name Dedeaux, Jillian R
Credentials CSFA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2021
Last updated Apr 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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