Doctor Name: | MRS. DANA BIANCA HARBISON |
NPI Number: | 1659477891 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 18319 |
Business Practice Address: | 1408 44th Ave Gulfport, MS - 395012554 |
Business Phone Number: | 2288675202 |
Business Fax Number: | 2288675007 |
Mailing Address: | 17600 Old River Rd, VANCLEAVE |
State: | MS |
Postal Code: | 395658706 |
Phone Number: | 2288260483 |
Fax Number: | 2288675007 |
NPI Enumeration Date: | 09/15/2006 |
NPI Last Update Date: | 09/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 18319 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MS |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |