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1639996952
KATHERINE MICHELLE BRUISTER
GULFPORT, MS
NPI
1639996952
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MS PA00833)
Enumeration Date
2024-09-26
Last Update Date
2024-09-26
Business Address
KATHERINE MICHELLE BRUISTER PA
4215 15TH ST
GULFPORT, MS 39501-2523
Phone number: 228-863-5211
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Mailing Address
KATHERINE MICHELLE BRUISTER PA
PO BOX 1810
GULFPORT, MS 39502-1810
Phone number: 228-863-5211
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