Durrell, Mia Ben'Na
Durrell, Mia Ben'Na is an sole proprietor health care provider with primary practice located at 100 Foxgate Ave Apt 31D , Hattiesburg MS 39402-1840. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Durrell, Mia Ben'Na can be contacted via phone (601) 597-9960.Contact Information
Primary practice address
100 Foxgate Ave Apt 31D
Hattiesburg MS 39402-1840
Phone: (601) 597-9960
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X |
Profile Details
| NPI number | 1619693199 |
|---|---|
| LBN Legal business name | Durrell, Mia Ben'Na |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2022 |
| Last updated | Oct 17th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619693199 | NPPES |
| Mississippi | Other | NLM131887957001 | BLUE CROSS BLUE SHIELD |
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