MRS. SHANNON KATHRYN GILMER (NPI# 1083673545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083673545 |
| Entity Type | Individual |
| Full Name | MRS. SHANNON KATHRYN GILMER |
| Other Name | SHANNON KATHRYN SMITH |
| Credential | PMHNP-BC |
| Practice Address |
4013 Beatline Rd Ste A Long Beach MS 39560-4135 |
| Mailing Address |
116 S Seashore Ave Long Beach MS 39560-5707 |
| Practice Telephone | 2282000720 |
| Mailing Telephone | 2283651124 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
903276 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4013 BEATLINE RD STE A |
| City | LONG BEACH |
| State | MS |
| Zip Code | 39560-4135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699242891 | Safe Harbor Clinic LLC | Counselor | 4013 Beatline Rd Ste A, Long Beach, MS 39560-4135 | 2018-10-26 |
| 1609352384 | Safe Harbor Clinic LLC | Social Worker | 4013 Beatline Rd Ste A, Long Beach, MS 39560 | 2018-07-16 |
| 1093135154 | Dustin Marmalich | Psychiatry & Neurology | 4013 Beatline Rd Ste A, Long Beach, MS 39560 | 2014-04-16 |
| 1356687396 | Lisa Ann Nelson | Social Worker | 4013 Beatline Rd Ste A, Long Beach, MS 39560-4135 | 2012-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1760889554 | Laura Catherine Ranson | Physical Therapist | 2 Tower Plaz, Suite B, Community Rehab Center, Long Beach, MS 39560 | 2014-11-24 |
| 1073803714 | Kathleen Ann Williams | Pharmacist | Riteaid #7227 Pharmacy 200 West Railroad St, Suite B, Long Beach, MS 39560 | 2011-04-14 |
| 1609177179 | Robert William Wylie | Hearing Instrument Specialist | 100 Larosa Rd, Ste D, Long Beach, MS 39560 | 2010-11-15 |
| 1891026498 | James Paul Bertinato | Speech-Language Pathologist | 20337 Longview Rd, Long Beach, MS 39560 | 2010-01-21 |
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1932362324 | Family Physical Therapy of South Ms LLC | Physical Therapist | 100-a La Rosa Rd, Long Beach, MS 39560 | 2008-07-07 |
| 1952589863 | Miller-whitmer Family Chiropractic | Chiropractor | 125 Jeff Davis Avenue, Long Beach, MS 39560 | 2008-02-01 |
| 1528267333 | Rachel S Conrad Md PC | Family Medicine | 100a Larosa, Long Beach, MS 39560 | 2007-07-12 |
| 1386720241 | Betty Diane Edrington | Registered Nurse | 2 Tower Plaza, Pineville Road, Long Beach, MS 39560 | 2006-10-31 |
| Find all providers in zip 39560 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720687015 | Ashley Winn | Nurse Practitioner | 367 E Chester St, Long Beach, NY 11561-2324 | 2020-10-19 |
| 1851458913 | Maryann B Powers | Nurse Practitioner | 59 W Olive St, Long Beach, NY 11561-3410 | 2007-01-01 |
| 1710085428 | Julie Valins | Nurse Practitioner | 871 E Park Ave, Long Beach, NY 11561-2709 | 2006-09-20 |
| 1508825761 | Jill Schmidt | Nurse Practitioner | 3416 Fela Ave, Long Beach, CA 90808-3209 | 2006-03-17 |
| 1295385581 | Adaobi Judith Afonta | Nurse Practitioner | 333 W Broadway Ste 310, Long Beach, CA 90802-4438 | 2019-09-18 |
| 1164088944 | Jessica Gerner Vadovicky | Nurse Practitioner | 4201 Long Beach Blvd Ste 203, Long Beach, CA 90807-2020 | 2019-05-16 |
| 1700399524 | Isis Alexandra Acosta | Nurse Practitioner | 200 Oceangate Ste 100, Long Beach, CA 90802-4317 | 2017-11-15 |
| 1225565104 | Sherwin Imperio | Nurse Practitioner | 4525 E Atherton St, Long Beach, CA 90815 | 2017-05-22 |
| 1528593340 | Diane Catherine Defilippo Nurse Practitioner In Psychiatry Pllc | Nurse Practitioner | 126 E Park Ave, Long Beach, NY 11561-3510 | 2017-04-30 |
| 1194275180 | Mhla, A Nursing Corporation | Nurse Practitioner | 5848 E Naples Plz, 201, Long Beach, CA 90803-5000 | 2016-10-13 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 39560 |
Please comment or provide details below to improve the information on MRS. SHANNON KATHRYN GILMER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.