Debbie Zachary, CNFP
Individual provider Active NPI Family Nurse Practitioner · Osyka, MS
NPI 1932158482 · NPPES record last updated May 14, 2013
Key facts
- NPI
- 1932158482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R501433 (MS)
- Practice address
- 1081 Second St
Osyka, MS 39657-8076 - Phone
- (601) 542-3300
- Fax
- (601) 542-5999
- NPI assigned
- May 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100526000620 | MS | Practitioner - Nurse Practitioner | 8820127004 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridging Community With Healthcare, LLC | Current |
Accepting new patients | |
| Jennifer D Gholson MD, LLC | Current |
Accepting new patients |
Locations
1005 W Congress St
Brookhaven, MS 39601
Phone (601) 833-6333
804 Robb St
Summit, MS 39666
Phone (601) 276-7665
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R501433 | MS | Yes |
Addresses
Primary practice location
1081 Second St
Osyka, MS 39657-8076
Mailing address
PO Box 351
Magnolia, MS 39652-0351
Phone (601) 542-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00117273 | Medicaid | MS |
Other providers in Osyka, MS
- Gracious Blessings LLC
- Healing Innovations LLC
- Blaire McMillan
- South Pike
- South Pike Hospital Association, Inc
All providers in Osyka, 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 May 14, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.