Racey, Jeannine A
Racey, Jeannine A is an individual health care provider with primary practice located at 1530 Broad Ave , Gulfport MS 39501-3601. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Racey, Jeannine A can be contacted via phone (228) 865-1330.Contact Information
Primary practice address
1530 Broad Ave
Gulfport MS 39501-3601
Phone: (228) 865-1330
Fax: (228) 865-1331
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | R725927 | Mississippi |
Profile Details
| NPI number | 1891711784 |
|---|---|
| LBN Legal business name | Racey, Jeannine A |
| Credentials | CGNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Mar 10th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891711784 | NPPES |
| Other | P00342756 | RAILROAD MEDICARE | |
| MEDICAID | 02858597 | RAILROAD MEDICARE |
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