IndividualActive
Justin Douglas
NPI 1073153433 · Registered Nurse First Assistant · Brookhaven, MS
Provider details
- NPI number
- 1073153433
- Entity type
- Individual
- Primary specialty
- Registered Nurse First AssistantNursing Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 854447 (MS)
Specialties & taxonomies
Nursing Service Providers
Practice location
427 Highway 51 N
Brookhaven, MS 39601-2350
Phone: (601) 835-9275
Fax: (888) 965-6812
Approximate (ZIP-level) locationGet directions
Mailing address
427 Highway 51 N
Brookhaven, MS 39601-2350
Registry dates
- Enumerated
- 2020-01-13
- Last updated
- 2020-01-13
- Certified
- 2020-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.