KATHERINE TUCKER (NPI# 1578946612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578946612 |
| Entity Type | Individual |
| Full Name | KATHERINE TUCKER |
| Credential | PA-C |
| Practice Address |
501 Marshall St Ste 104 Jackson MS 39202-1663 |
| Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
| Practice Telephone | 6019696404 |
| Practice Fax Number | 6019734541 |
| Mailing Fax Number | 9012278591 |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2020-01-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA00464 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA.200837 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7777 Hennessy Blvd Ste 8001, Baton Rouge, LA 70808 | 2254907224 | 2254907223 |
| 6565 Fannin St, Houston, TX 770302703 | 7133322539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972918134 | Katherine Tucker | Social Worker | 635 S Maple Rd Ste 2, Ann Arbor, MI 48103-3838 | 2014-06-26 |
| 1174827000 | Katherine S Tucker | Massage Therapist | 132 River Rd, Clinton, CT 06413-1053 | 2011-01-06 |
| 1225269814 | Katherine Louise Tucker | Physical Therapist | 5s530 Scots Dr, Apartment 18f, Naperville, IL 60563-9000 | 2009-07-31 |
| 1760835334 | Katherine Tucker | Specialist/Technologist | 1000 N Main St, Findlay, OH 45840-3653 | 2016-07-19 |
| 1932568482 | Katherine A Tucker | Nurse Practitioner | 1739 N 4th St, Terre Haute, IN 47804-4002 | 2016-02-12 |
| 1255770590 | Katherine Tucker | Social Worker | 9265 Shore Rd, Apt. 1a, Brooklyn, NY 11209-6576 | 2013-06-20 |
| 1245674571 | Katherine R Tucker | Obstetrics & Gynecology | 170 Manning Dr, Chapel Hill, NC 27599-7572 | 2013-04-17 |
| 1861741936 | Katherine Ann Tucker | Counselor | 601 N Market Blvd, Suite 350, Sacramento, CA 95834-1200 | 2012-09-05 |
| 1467735811 | Katherine E Tucker | Social Worker | 2118 3 Mile Rd Nw, Grand Rapids, MI 49544-1425 | 2011-09-22 |
| 1114257169 | Katherine Elizabeth Tucker | Nurse Practitioner | 789 Howard Ave, New Haven, CT 06519-1304 | 2010-01-13 |
| Street Address |
501 MARSHALL ST STE 104 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557013 | Frank Nelson Haugland | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2005-09-09 |
| 1760956247 | Siera Cheyenne Shiyou | Physician Assistant | 501 Marshall St Ste 104, Jackson, MS 39202 | 2019-01-17 |
| 1346751195 | Amy Wall | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2017-10-19 |
| 1811396971 | Rachel P Hearst | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2014-08-14 |
| 1902235583 | Judith Stallings | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-11-05 |
| 1508206913 | Stephen David Anderson | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-06-28 |
| 1205178241 | Shanna Amisha Tolbert Craven | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-03-16 |
| 1275897670 | Patrick Ross Thurmond | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2012-06-29 |
| 1275893638 | Derek Paul De Grijs | Surgery | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2012-05-20 |
| 1215249016 | Rishi Ashok Roy | Surgery | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2010-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1275163727 | Kaitlin Lehto | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4684 | 2020-01-23 |
| 1154951739 | Hailey Daniels Kelly | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-22 |
| 1205466984 | Rachel Sellers | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2020-01-22 |
| 1194284786 | Kaitlyn Dunbar | Physician Assistant | 2500 N State St, Jackson, MS 39216-4500 | 2019-03-14 |
| 1164920930 | Catherine Supple Bryant | Physician Assistant | 1190 N State St Ste 502, Jackson, MS 39202-2414 | 2018-01-26 |
| 1790293496 | Madison Holcomb | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2018-01-16 |
| 1902314693 | Sarah Lindsey Abdeen | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2018-01-16 |
| 1083073233 | Mary Allison Durr | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-02-16 |
| Find all providers in JACKSON | ||||
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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.