Organization Name: | THE DIABETES CENTER, PLLC |
NPI Number: | 1043391436 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN C ARNOLD (OWNER) |
Mailing Address: | 3099 Bienville Blvd Ocean Springs |
State: | MS US |
Postal Code: | 395644308 |
Phone Number: | 2288753606 |
Fax Number: | 2288753687 |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | R854239 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |