JESSICA FUQUA

GULFPORT, MS
NPI1235548363
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  902207)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: TN  18863)
363LF0000X Nurse Practitioner, Family
(Licence: NM  CNP-02586)
Enumeration Date2014-08-02
Last Update Date2022-07-21
Business Address
Mrs. JESSICA FUQUA NP-C
1530 BROAD AVE
GULFPORT, MS 39501-3601
Phone number: 228-865-1330
Mailing Address
Mrs. JESSICA FUQUA NP-C
38 PASS RD STE A
GULFPORT, MS 39507-3107
Phone number: 228-865-1330