Knowlton, Susan

Knowlton, Susan is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Knowlton, Susan can be contacted via phone (228) 863-1132.

Contact Information

Primary practice address
1600 Broad Ave Gulfport MS 39501-3603
Phone: (228) 863-1132
Fax: (228) 865-1700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X R865348 Mississippi

Profile Details

NPI number 1982623393
LBN Legal business name Knowlton, Susan
Credentials FPMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Apr 16th, 2014 - about 10 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 1982623393 NPPES
Mississippi MEDICAID 00018213
Mississippi MEDICAID 01520708

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