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1922237452
ONELLIS STANFORD
GULFPORT, MS
NPI
1922237452
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R869199)
Enumeration Date
2009-07-06
Last Update Date
2014-07-11
Business Address
-- ONELLIS STANFORD FNP
1340 BROAD AVE SUITE 310
GULFPORT, MS 39501-2404
Phone number: 228-575-1400
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Mailing Address
-- ONELLIS STANFORD FNP
PO BOX 1810
GULFPORT, MS 39502-1810
Phone number: 228-864-8454
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