MRS. HEATHER LYNN THEISEN (NPI# 1750879003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750879003 |
| Entity Type | Individual |
| Full Name | MRS. HEATHER LYNN THEISEN |
| Credential | ARNP |
| Practice Address |
15190 Community Rd Ste 330 Gulfport MS 39503 |
| Mailing Address |
15190 Community Rd Ste 330 Gulfport MS 39503-3498 |
| Practice Telephone | 2283281401 |
| Mailing Telephone | 2823281401 |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
902515 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15190 COMMUNITY RD STE 330 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| 1902257421 | Carlos Evers | Specialist/Technologist | 14046 North White Swan Dr, Gulfport, MS 39503 | 2016-06-27 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902847163 | Patricia Danielle Hall | Nurse Practitioner | 12100 Highway 49, Gulfport, MS 39503-3063 | 2006-06-09 |
| 1093320053 | Joanne Tuyen Mong Nguyen | Nurse Practitioner | 11240 Highway 49, Gulfport, MS 39503-4151 | 2020-09-15 |
| 1386057602 | Amanda Levens | Nurse Practitioner | 9454 Three Rivers Rd, Suite A, Gulfport, MS 39503-4294 | 2014-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142943 | Ashley B Chittenden | Nurse Practitioner | 3480 Avis Ln, Southaven, MS 38672-2010 | 2020-10-23 |
| 1437760881 | Elizabeth Smith | Nurse Practitioner | 3631 Bienville Blvd Ste A, Ocean Springs, MS 39564-5702 | 2020-08-10 |
| 1972021608 | Dana Brooke Underwood | Nurse Practitioner | 1300 Access Rd Ste 400, Oxford, MS 38655-5211 | 2017-09-01 |
| 1891233276 | Optimum Healthcare Associates, Pa | Nurse Practitioner | 5350 Executive Pl, Suite 8, Jackson, MS 39206-4100 | 2017-02-06 |
| 1386020113 | Stefanie Taylor Christy | Nurse Practitioner | 3654b New Hope Rd, Columbus, MS 39702-8521 | 2015-08-04 |
| 1861808974 | Ashley Hickman | Nurse Practitioner | 224 S Church St Ste B, Brookhaven, MS 39601-3232 | 2014-07-09 |
| 1528486289 | Thomas Stallworth | Nurse Practitioner | 4105 Hospital St Ste 104, Pascagoula, MS 39581 | 2014-03-31 |
| 1962744482 | Kendra Watts | Nurse Practitioner | 1016 Sixth Ave Ste C, Picayune, MS 39466-3861 | 2013-03-22 |
| 1730340563 | Kayti A Powell | Nurse Practitioner | 1488 Hwy 487 East, Sebastopol, MS 39359-0150 | 2008-06-24 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
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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.