Lydia J Burden, B.S. HUMAN SERVICES
Individual provider Active NPI Case Manager/Care Coordinator · Gautier, MS
NPI 1861803751 · NPPES record last updated May 13, 2014
Key facts
- NPI
- 1861803751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 3407 Shamrock CT
Gautier, MS 39553-5337 - Phone
- (228) 497-0690
- Fax
- (228) 497-1363
- NPI assigned
- May 13, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
3407 Shamrock CT
Gautier, MS 39553-5337
Mailing address
3407 Shamrock CT
Gautier, MS 39553-5337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018214 | Medicaid | MS |
Other providers in Gautier, MS
- Linda Gail Bratcher
- Clifford Wayne Brewer
- Brandon Brown
- Lakendra A Brown
- Zoe Marine Brown
- Travis Allen Burdick
- Benjamin Edwin Burgess
- Rachel Nicole Burnett
- Burnham-McKinney Pharmacy No 3 LLC
- Judy A Busby
All providers in Gautier, MS · Case Manager/Care Coordinator in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2014. 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.