Ditta, Peggy

Ditta, Peggy is an sole proprietor health care provider with primary practice located at 15190 Community Rd Suite 230A, Gulfport MS 39503-3485. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Ditta, Peggy can be contacted via phone (228) 831-0204.

Contact Information

Primary practice address
15190 Community Rd Suite 230A Gulfport MS 39503-3485
Phone: (228) 831-0204
Fax: (228) 831-1868
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R863345 Mississippi

Profile Details

NPI number 1629173174
LBN Legal business name Ditta, Peggy
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2006
Last updated Jul 8th, 2007 - about 18 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 1629173174 NPPES
Mississippi MEDICAID 01727241

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