LISSA KELLY BABER (NPI# 1306409040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306409040 |
Entity Type | Individual |
Full Name | LISSA KELLY BABER |
Credential | AGACNP |
Practice Address |
1340 Broad Ave Gulfport MS 39501-2404 |
Mailing Address |
5 Oak Alley Ln Long Beach MS 39560-8000 |
Practice Telephone | 2288675012 |
Mailing Telephone | 6014330575 |
Enumeration Date | 2019-04-18 |
Last Update Date | 2019-06-30 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
903259 | MS | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
4500 13th St, Gulfport, MS 395012569 | 2288674000 |
Street Address |
1340 BROAD AVE |
City | GULFPORT |
State | MS |
Zip Code | 39501-2404 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912904590 | Jesse Pullen Penico | Internal Medicine | 1340 Broad Ave, Suite 300, Gulfport, MS 39501-2404 | 2005-06-28 |
1780191577 | Tbd Acquisition II LLC | Social Worker | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2018-01-03 |
1629517115 | Delana Mooney | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2017-02-16 |
1396299590 | Charles Strange | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2016-08-05 |
1942699988 | Beth Ann Gruzinskas | Nurse Practitioner | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2015-01-14 |
1720477714 | Lacey Grimes Lichtenstein | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2015-01-14 |
1669872974 | Jamie B Varnado | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2014-08-25 |
1700121209 | Danielle Ronquille Lipski | Occupational Therapist | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2012-12-10 |
1164767778 | Shannon Ann Church | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2012-12-07 |
1649552563 | Taylor E. Covington | Physician Assistant | 1340 Broad Ave, Suite 210, Gulfport, MS 39501-2404 | 2011-09-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
Find all providers in zip 39501 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588212229 | David Buckheister | Nurse Practitioner | 612 Liz Cir, Gulfport, MS 39503-3712 | 2019-08-27 |
1710209184 | Amy Alyssa Simpson-waid | Nurse Practitioner | 11334 Peyton Dr, Gulfport, MS 39503 | 2010-02-25 |
1457543183 | Diane C. Jakins | Nurse Practitioner | 400 Security Sq, Gulfport, MS 39507-1932 | 2007-08-16 |
1891289955 | Brittany L Stewart | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2018-06-21 |
1023469244 | Michelle Wright Taylor | Nurse Practitioner | 15190 Community Rd, Ste 220, Gulfport, MS 39503-3485 | 2016-06-29 |
1295107357 | Tammy Vincent | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2015-10-28 |
1023417938 | Carla Ann Rushing | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2014-08-15 |
1972910230 | Elizabeth Drummond | Nurse Practitioner | 1391 Broad Ave, Gulfport, MS 39501-2419 | 2014-07-18 |
1932527264 | Brandi Saksa | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2014-04-03 |
1346684925 | Darlene Ann Petersen | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2013-04-25 |
Find all providers in GULFPORT |
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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.