Keeley Grace Awwad, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

906308 Issued in MS

Practice address

1710 N Gloster St
Tupelo, MS 38804-1216

Phone

(662) 840-6824

NPI assigned

Mar 8, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1760240337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 COUNTY ROAD 5211",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388299422",
            "telephone_number": "662-416-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041216",
            "telephone_number": "662-840-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWWAD",
        "first_name": "KEELEY",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Brooks Averette, MD
• Jeffrey Michael Avery, C.R.N.A.
• Maurice Avery, BA
• Avonlea Opco LLC
• Hussein Mohamed Awwad, MD
• Hannah Aycox
• Adnan Arshad Aziz, M.D.
• Lauren McGee Babb, FNP-C
• Terry Baber, BS
• Delores Badie

• Family Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.