Provider Demographics
NPI:1427289677
Name:SMITH, LORING JOHN JR (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:LORING
Middle Name:JOHN
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1641 POPPS FERRY RD STE A3
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2226
Mailing Address - Country:US
Mailing Address - Phone:228-232-0890
Mailing Address - Fax:228-232-0891
Practice Address - Street 1:400 VETERANS AVE
Practice Address - Street 2:BLDG. T-100
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2410
Practice Address - Country:US
Practice Address - Phone:228-523-4784
Practice Address - Fax:228-523-5959
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2022-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MSR662992163WP0809X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult