Gavin, Pamela

Gavin, Pamela is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Gavin, Pamela can be contacted via phone (601) 261-3606.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 261-3606
Fax: (601) 579-5166
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 903101 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R863555 Mississippi

Profile Details

NPI number 1871781997
LBN Legal business name Gavin, Pamela
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2007
Last updated Aug 10th, 2020 - about 4 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 1871781997 NPPES
Mississippi MEDICAID 03010781

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