Suber, Traci Davis

Suber, Traci Davis is an individual health care provider with primary practice located at 421 S 28Th Ave Ste 200 , Hattiesburg MS 39401-7208. 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 / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Suber, Traci Davis can be contacted via phone (601) 268-5640.

Contact Information

Primary practice address
421 S 28Th Ave Ste 200 Hattiesburg MS 39401-7208
Phone: (601) 268-5640
Fax: (601) 579-5240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 814179 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X R814179 Mississippi

Profile Details

NPI number 1962628966
LBN Legal business name Suber, Traci Davis
Credentials Women's Health Nurse Practitioner (WHNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2007
Last updated Aug 11th, 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 1962628966 NPPES
Mississippi MEDICAID 00118984
Mississippi Other 12181303
Mississippi Other 2285175
Mississippi Other 7059463

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