Kassie Stafford, PA
Physician Assistant in Pass Christian, MS. Individual provider (NPI-1).
NPI number1245567775
StatusActive
Last updated in NPPESOct 18, 2024
Details
- NPI
- 1245567775
- Entity type
- Individual (NPI-1)
- Name
- Kassie Stafford
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2009
- Certification date
- Oct 18, 2024
- Last updated
- Oct 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA00128 | MS | Yes |
| 363A00000X | Physician Assistant | PA.200296 | LA |
Practice location
116 Menge Ave Apt APass Christian, MS 39571-4738
Phone 228-586-9565 · Fax 228-864-3333
Mailing address
11295 E. Taylor RoadGulfport, MS 39503-4197
Phone 228-864-3300 · Fax 228-864-3333
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.