Provider Demographics
NPI:1578128336
Name:JUMPIERE, DOROTHY HOLMES
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:HOLMES
Last Name:JUMPIERE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:HOLMES
Other - Last Name:JUMPIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:6 LAZY MDW
Mailing Address - Street 2:
Mailing Address - City:CARRIERE
Mailing Address - State:MS
Mailing Address - Zip Code:39426-8196
Mailing Address - Country:US
Mailing Address - Phone:228-363-1502
Mailing Address - Fax:601-798-4588
Practice Address - Street 1:1514 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3006
Practice Address - Country:US
Practice Address - Phone:228-382-9222
Practice Address - Fax:228-382-9224
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily