KANIESHIA M MITCHELL (NPI# 1629614003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629614003 |
| Entity Type | Individual |
| Full Name | KANIESHIA M MITCHELL |
| Credential | NP |
| Practice Address |
4500 13th St Gulfport MS 39501-2569 |
| Practice Telephone | 2288674000 |
| Mailing Telephone | 2288674000 |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2020-04-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 903399 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4500 13TH ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
| 1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
| 1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
| 1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
| 1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
| 1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
| 1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
| 1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
| 1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
| 1083265185 | Trinh Thu Weatherly | Nurse Anesthetist, Certified Registered | 4500 13th St, Gulfport, MS 39501-2569 | 2019-09-20 |
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356960777 | Jennifer M Hunter | Nurse Practitioner | 8970 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-04-15 |
| 1831720242 | Amanda R Woodcock | Nurse Practitioner | 1391 Broad Ave Ste A, Gulfport, MS 39501-2419 | 2020-02-04 |
| 1528428182 | Teresa Kay Guy | Nurse Practitioner | 6107 Kipps Colony Dr W, Gulfport, FL 33707-3969 | 2016-02-25 |
| 1255608816 | 828 Walk In Clinic | Nurse Practitioner | 12207 Hwy 49, Suite 40, Gulfport, MS 39503 | 2011-11-28 |
| 1326343484 | Kelli Michelle Garrigues | Nurse Practitioner | 1110 Broad Ave Ste 700, Gulfport, MS 39501-8908 | 2011-01-21 |
| 1386815694 | Heather Nicole Swann | Nurse Practitioner | 4333 15th St Ste B, Gulfport, MS 39501 | 2008-03-13 |
| 1013064245 | Leigh P Drace | Nurse Practitioner | 394 Courthouse Rd Ste A, Gulfport, MS 39507-1866 | 2007-01-03 |
| 1801987870 | Primesource Nursing Services, Inc | Nurse Practitioner | 4906 Kendall Ave, Gulfport, MS 39507-4409 | 2006-09-27 |
| 1659477693 | Gary Dalton Gentry | Nurse Practitioner | 4500 13th Street, Wound Care, Gulfport, MS 39501 | 2006-09-16 |
| 1487673406 | Katherine P Griffis | Nurse Practitioner | 38 Pass Rd Ste A, Gulfport, MS 39507-3107 | 2006-07-19 |
| 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.