Wakham, Brenda

Wakham, Brenda is an individual health care provider with primary practice located at 4500 13Th St , Gulfport MS 39501-2569. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wakham, Brenda can be contacted via phone (228) 867-4000.

Contact Information

Primary practice address
4500 13Th St Gulfport MS 39501-2569
Phone: (228) 867-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R702285 Mississippi

Profile Details

NPI number 1437267119
LBN Legal business name Wakham, Brenda
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Jan 14th, 2019 - about 6 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 1437267119 NPPES
Mississippi MEDICAID 07051371

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