St Michaels Urgent Care of Hattiesburg
Organization Active NPI Family Nurse Practitioner · Hattiesburg, MS
NPI 1124459136 · NPPES record last updated Sep 6, 2016
Key facts
- NPI
- 1124459136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R875464 (MS)
- Legal business name
- ST MICHAELS URGENT CARE OF HATTIESBURG
- Practice address
- 3700 Hardy St
Hattiesburg, MS 39402-1610 - Phone
- (601) 602-2014
- Fax
- (601) 602-2015
- NPI assigned
- Dec 2, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- INLAND FAMILY PRACTICE CENTER
Authorized official
- Name
- Marva Joyce Cooley, CPC
- Title
- Credentialling Director
- Phone
- (601) 909-2539
Parent organization (reported in NPPES) 1
Practitioners 15
-
Kaylora L Bingham, FNP-C
-
Tammie R Jenkins, MSN, FNP
-
Shannon Nicole Seals, FNP
-
Kelsa Shirley, FNP
-
Mary Sue Watkins, CFNP
-
Nikki J Clark, FNP-BC
-
Dayna Hamm Pridgen, FNP
-
Jeremy Stewart, N.P/
-
Carmen Campbell Trawick, FNP-BC
-
Pilar Lyas, AGNP
National Provider Directory
- Part of
- Adeline After-Hour Care LLC
Locations
3700 Hardy St
Ste 10
Hattiesburg, MS 39402
Phone (601) 544-7012
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | |||
| Family Nurse Practitioner |
363LF0000X | R875464 | MS | Yes |
Addresses
Primary practice location
3700 Hardy St
Hattiesburg, MS 39402-1610
Mailing address
3700 Hardy St
Hattiesburg, MS 39402-1610
Phone (601) 602-2014
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00776879 | Medicaid | MS |
Other providers in Hattiesburg, MS
- Melissa Springfield
- Kristen Sicard Spruill
- St Joseph Hospice of Southern Mississippi, LLC
- St Luke Missionary Hospice LLC
- St Michael Urgent Care of Hattiesburg LLC
- Karol Scott St. Louis
- Amanda Elizabeth Stafford
- Reagan Aldridge Standland
- Tyler Standland
- Lowry C Stanford Jr.
All providers in Hattiesburg, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.