DR. JOHNNIE SUSAN COOPER WIJEWARDANE (NPI# 1316196850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316196850 |
| Entity Type | Individual |
| Full Name | DR. JOHNNIE SUSAN COOPER WIJEWARDANE |
| Credential | PHD, FNP |
| Practice Address |
1430 Cedar Creek Ln Starkville MS 39759-8488 |
| Practice Telephone | 6623121021 |
| Mailing Telephone | 6623121021 |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2012-03-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R852708 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04887214 | 05 |
| Street Address |
1430 CEDAR CREEK LN |
| City | STARKVILLE |
| State | MS |
| Zip Code | 39759-8488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749274 | Medplus Starkville LLC | Clinic/Center | 1207 Ms 182, Starkville, MS 39759 | 2020-10-29 |
| 1033726930 | Katherine Campbell | Counselor | 796 Us 45 Alternate South, Starkville, MS 39759 | 2020-09-25 |
| 1275145781 | Amanda Allred | Nurse Practitioner | 59 Lynn Lane, Starkville, MS 39759 | 2020-08-18 |
| 1477174928 | Tina Whitehead | Massage Therapist | 518 Hwy 12 W, Starkville, MS 39759 | 2020-05-06 |
| 1699334284 | Ashley Kelton | Speech-Language Pathologist | Speech Therapy for Kids, 1411 Highway 389, Starkville, MS 39759 | 2019-06-07 |
| 1851850838 | Austin Fitzpatrick | Specialist/Technologist | 145 Lakeview Drive, Starkville, MS 39759 | 2019-03-18 |
| 1730645243 | Methodist of Mississippi Hospital & Rehabilitation Center | Durable Medical Equipment & Medical Supplies | 101 G T Thames Dr, Starkville, MS 39759 | 2019-02-20 |
| 1457854648 | Ryan Lamar Dotson | Specialist/Technologist | 55 Coliseum Blvd, Starkville, MS 39759 | 2018-03-14 |
| 1679085948 | Alan Evans | Specialist | 106 North Lafayette St, Starkville, MS 39759 | 2017-10-26 |
| 1275057275 | Southern Foundation for Homeless Children | Home Health | 317 Martin Luther King Drive, Suite 102, Starkville, MS 39759 | 2017-08-01 |
| Find all providers in zip 39759 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194377226 | Wecare Health Clinic | Nurse Practitioner | 823 Highway 12 W Ste C, Starkville, MS 39759-3593 | 2019-07-09 |
| 1689131401 | Amy Morgan Cain | Nurse Practitioner | 200 White Oak Ln, Starkville, MS 39759-6663 | 2019-02-28 |
| 1740744572 | Klancie Allison Smith | Nurse Practitioner | 1233 Steele Rd, Starkville, MS 39759-4723 | 2019-01-25 |
| 1114111978 | Meredith Patton Hartline | Nurse Practitioner | 500 Russell St Ste 3, Starkville, MS 39759-5411 | 2007-09-04 |
| 1992881882 | Bethany Lee Greco | Nurse Practitioner | 732 Whitfield Street, Mississippi State Board of Health District Iv, Starkville, MS 39759 | 2006-10-31 |
| 1508802208 | Courtney Gibson Nickels | Nurse Practitioner | 1207 Highway 182 W, Starkville, MS 39759-9820 | 2006-06-21 |
| 1679174403 | Kimberlin Cotton | Nurse Practitioner | 401 Hospital Rd, Starkville, MS 39759-2164 | 2020-11-06 |
| 1497389902 | Lydia Ruth Rice | Nurse Practitioner | 900 Stark Rd, Starkville, MS 39759-3613 | 2020-02-24 |
| 1376180992 | Catherine Eldridge | Nurse Practitioner | 100 Wilburn Way, Starkville, MS 39759-3692 | 2019-12-02 |
| 1023581857 | Jana Louann Peterson | Nurse Practitioner | 400 Hospital Rd, Starkville, MS 39759-2163 | 2019-01-03 |
| Find all providers in STARKVILLE | ||||
| City | STARKVILLE |
| Zip Code | 39759 |
Please comment or provide details below to improve the information on DR. JOHNNIE SUSAN COOPER WIJEWARDANE.
| 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.