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Contact Information

LISSA K BABER, AGACNP
1340 BROAD AVE
GULFPORT, MS39501-2404
 Phone: 228-867-5012
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LISSA K BABER · (Female)

NPI Number 1306409040
Status Active
Credentials AGACNP
Entity Individual
Enumeration date 04/18/2019
Last updated 06/30/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 903259
Hospital affiliation(s)
  • MEMORIAL HOSPITAL AT GULFPORT - (Acute Care)
    4500 13TH ST-P O BOX 1810
    GULFPORT, MS 39502
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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