Provider Demographics
NPI:1558651877
Name:DUSENBURY, KATHLEEN BET (MS)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:BET
Last Name:DUSENBURY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 FISHER ST
Mailing Address - Street 2:KEESLER MEDICAL CENTER/ 81 MDOS/SGOU
Mailing Address - City:KEESLER AFB
Mailing Address - State:MS
Mailing Address - Zip Code:39534-2508
Mailing Address - Country:US
Mailing Address - Phone:228-376-5611
Mailing Address - Fax:228-376-0168
Practice Address - Street 1:301 FISHER ST
Practice Address - Street 2:KEESLER MEDICAL CENTER/ 81 MDOS/SGOU
Practice Address - City:KEESLER AFB
Practice Address - State:MS
Practice Address - Zip Code:39534-2508
Practice Address - Country:US
Practice Address - Phone:228-376-5611
Practice Address - Fax:228-376-0168
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS