Fairley, Joanne

Fairley, Joanne is an sole proprietor health care provider with primary practice located at 14116 Customs Blvd , Gulfport MS 39503-5164. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Fairley, Joanne can be contacted via phone (601) 957-6300.

Contact Information

Primary practice address
14116 Customs Blvd Gulfport MS 39503-5164
Phone: (601) 957-6300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R781853 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X R781853 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 281478 Arizona

Profile Details

NPI number 1972984136
LBN Legal business name Fairley, Joanne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2015
Last updated Oct 4th, 2022 - about 3 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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