Douglas, Amy R

Douglas, Amy R is an sole proprietor health care provider with primary practice located at 1 Lincoln Pkwy Ste 302 , Hattiesburg MS 39402. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Douglas, Amy R can be contacted via phone (601) 579-5400.

Contact Information

Primary practice address
1 Lincoln Pkwy Ste 302 Hattiesburg MS 39402
Phone: (601) 579-5400
Fax: (601) 579-5240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R857450 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X R857450 Mississippi

Profile Details

NPI number 1801199666
LBN Legal business name Douglas, Amy R
Credentials DNP, FNP-BC, WHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2010
Last updated Aug 22nd, 2018 - 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 1801199666 NPPES
Mississippi MEDICAID 00127100

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