Nurse Practitioner Professionals, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NURSE PRACTITIONER PROFESSIONALS, PLLC

Doing business as

Theresa Renee King

Practice address

427 Highway 51 SE
Kings Daughters Medical Center-Wound Healing Center
Brookhaven, MS 39601

Phone

(601) 835-9444

Fax

(601) 833-5210

NPI assigned

Jun 23, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Theresa Renee King, CFNP

Title

Owner/Pres. Nurse. Practitioner

Phone

(601) 826-5500

Specialties & licenses 1

Addresses

Other names 1

• Theresa Renee King Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1205218690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 CORNERSTONE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39042",
            "telephone_number": "601-826-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 HIGHWAY 51 SE",
            "address_2": "KINGS DAUGHTERS MEDICAL CENTER-WOUND HEALING CENTER",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-835-9444",
            "fax_number": "601-833-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE PRACTITIONER PROFESSIONALS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER/PRES.  NURSE. PRACTITIONER",
        "authorized_official_telephone_number": "601-826-5500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theresa Renee King",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• New Viality
• Ashton Kyle Newman, FNP-C
• Shamekia Nichols
• Krhistyn Dimetrias Noble
• James Larry Nordin
• Samantha Occhipinti, MS, CCC-SLP
• Ole Brook Kids, P.C.
• Ole Brook Optical, Inc
• Passionate Care Home Health,LLC
• Shannon P Patterson, DMD

• Ambulatory Surgical Clinic/Center in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.