Jennivie Chrishae Bouie, LPN
Individual provider Active NPI Licensed Practical Nurse · Magee, MS
NPI 1265017339 · NPPES record last updated Mar 10, 2021
Key facts
- NPI
- 1265017339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 337263 (MS)
- Practice address
- 115 Hawpond Church Rd
Magee, MS 39111 - Phone
- (601) 405-2956
- NPI assigned
- Mar 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337263 | MS | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 337263 | MS | Yes |
Addresses
Primary practice location
115 Hawpond Church Rd
Magee, MS 39111
Mailing address
115 Hawpond Church Rd
Magee, MS 39111
Phone (601) 405-2956
Other providers in Magee, MS
- Boswell Regional Center
- Boswell Regional Center
- Boswell Regional Center
- Boswell Regional Center
- Boswell Regional Center
- Ashley Bounds
- Sadie R Bourne
- Brandi'S Hope Community Services
- Olivia Carsyn Burch
- Ashley Burke
All providers in Magee, MS · Licensed Practical Nurse in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2021. 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.