White, Corey

White, Corey is an sole proprietor health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. White, Corey can be contacted via phone (601) 261-3606.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 261-3606
Fax: (601) 579-5383
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R881143 Mississippi

Profile Details

NPI number 1093144438
LBN Legal business name White, Corey
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2013
Last updated Aug 10th, 2020 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1093144438 NPPES
Mississippi MEDICAID 04279758

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