Takila Terrell
Individual provider Active NPI Licensed Practical Nurse · Shubuta, MS
NPI 1912736612 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1912736612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 337650 (MS)
- Practice address
- 361 County Road 222
Shubuta, MS 39360-9510 - Phone
- (769) 317-4142
- NPI assigned
- Jul 31, 2024
- Sex
- Female
- Sole proprietor
- No
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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337650 | MS | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tiermax Homecare Services | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 337650 | MS | Yes |
Addresses
Primary practice location
361 County Road 222
Shubuta, MS 39360-9510
Mailing address
361 County Road 222
Shubuta, MS 39360-9510
Other providers in Shubuta, MS
- Brittany N Powe
- Patricia Simpson
- Chasity Michelle Sisson
- Superior Home Care
- Superior Home Care
- The Magnolia Center
- Tiermax Homecare Services
- Virgie C Wade
All providers in Shubuta, 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 Jul 31, 2024. 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.