Jasmine Kinata Minnis, APRN, ACNPC- AG

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

899062 Issued in MS

Practice address

9141 Mallard Park Blvd
Walls, MS 38680-8003

Phone

(901) 907-7676

NPI assigned

Sep 7, 2021

Last updated

May 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1265100093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 MALLARD PARK BLVD",
            "city": "WALLS",
            "state": "MS",
            "postal_code": "386808003",
            "telephone_number": "901-907-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 MALLARD PARK BLVD",
            "city": "WALLS",
            "state": "MS",
            "postal_code": "386808003",
            "telephone_number": "901-907-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIS",
        "first_name": "JASMINE",
        "middle_name": "KINATA",
        "name_prefix": "Dr.",
        "credential": "APRN, ACNPC- AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "904928",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "29597",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MS",
            "license": "899062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosalind House
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• Wendy McKenzie
• Metro Treatment of Mississippi LP (Desoto County Treatment Center)
• Mississippi CVS Pharmacy LLC (CVS Pharmacy # 03426)
• Christian Muenyi, PHARM.D
• Kimberly K Nesbitt, M.D.
• Lashonda Netterville
• Kenyia Noble

• General Practice Registered Nurse in Walls, MS
• Providers in Walls, MS by specialty
• General Practice Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.