Provider Demographics
NPI:1043977507
Name:PEARSON CROSBY, FAITH ANNE (CNP)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:ANNE
Last Name:PEARSON CROSBY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:ANNE
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-575-1194
Mailing Address - Fax:228-575-2917
Practice Address - Street 1:394 COURTHOUSE RD STE A
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-1866
Practice Address - Country:US
Practice Address - Phone:228-896-4417
Practice Address - Fax:228-604-0121
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904986363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner