Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1790773034

Unknown Individual is a healthcare provider. based in Gulfport, Mississippi. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R861931 (MS). The NPI Number for Unknown Individual is 1790773034

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790773034
Phone
(228) 832-1106
Address
16247 NORTHRUP CUEVAS RD
Deactivation Date
28 February 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 16247 NORTHRUP CUEVAS RD

    GULFPORT, MS 395039245

    Phone: (228) 832-1106

    Type: Mailing

  • Medical Park Drive, Biloxi, Harrison County, Mississippi, 39532, United States

    BILOXI, MS 395322131

    Phone: (228) 702-2000

    Fax: (228) 702-2019

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 39503)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1790773034?
NPI 1790773034 belongs to Unknown Individual; compare other details if you need extra assurance.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Gulfport, Mississippi as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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