IndividualActive
Heather Theisen, ARNP
NPI 1750879003 · Pediatric Nurse Practitioner · Gulfport, MS
Provider details
- NPI number
- 1750879003
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- No
- License
- 902515 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
15190 Community Rd Ste 330
Gulfport, MS 39503
Phone: (228) 328-1401
Approximate (ZIP-level) locationGet directions
Mailing address
15190 Community Rd Ste 330
Gulfport, MS 39503-3498
Registry dates
- Enumerated
- 2018-04-23
- Last updated
- 2018-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.