Provider Demographics
NPI:1629650452
Name:KIRBY, ADRIENNE DIANNE HOGUE (WHNP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DIANNE HOGUE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:DIANNE
Other - Last Name:HOGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13737 PUERTO DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2549
Mailing Address - Country:US
Mailing Address - Phone:228-365-4765
Mailing Address - Fax:
Practice Address - Street 1:14231 SEAWAY RD STE 3004
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4653
Practice Address - Country:US
Practice Address - Phone:288-206-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS909859163W00000X
MS905986363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse