Tammie C Waters, CFNP
Individual provider Active NPI Family Nurse Practitioner · Baldwyn, MS
NPI 1770636243 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1770636243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R574929 (MS)
- Practice address
- 305 Mill St
Baldwyn, MS 38824-2122 - Phone
- (662) 365-3253
- Fax
- (662) 365-3484
- NPI assigned
- Jan 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R574929 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waters Family Health Care | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R574929 | MS | Yes |
Addresses
Primary practice location
305 Mill St
Baldwyn, MS 38824-2122
Mailing address
305 Mill St
Baldwyn, MS 38824-2122
Phone (662) 365-3253
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32-0073167 | Other | MS | HEALTHLINK |
| 32-0073167 | Other | MS | BLUE CROSSBLUE SHIELD |
| 32-0073167 | Other | MS | CIGNA |
| 32-0073167 | Other | MS | AETNA |
| 03222231 | Medicaid | MS | |
| 32-0073167 | Other | MS | UNITED HEALTHCARE |
| 32-0073167 | Other | MS | BAPTIST |
Other providers in Baldwyn, MS
- Thirty-Three Medspa
- Anita Joy Turner
- Turner, LLC
- VML Medical Services of Booneville Inc
- Waters Family Health Care
- Amanda Watson
- Ericka Marcene Williams
All providers in Baldwyn, 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 Jul 8, 2007. 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.