BERTHA SIEDAH SULLIVN (NPI# 1831729417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831729417 |
| Entity Type | Individual |
| Full Name | BERTHA SIEDAH SULLIVN |
| Credential | RN |
| Practice Address |
635 Hampton Way Apt C Jackson MS 39211-2300 |
| Mailing Address |
635 Hampton Way Jackson MS 39211-2300 |
| Practice Telephone | 6624662208 |
| Mailing Telephone | 6624662208 |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 141-222 | AL | Nursing Service Providers |
| Y | 163W00000X | Registered Nurse | 895742 | MS | Nursing Service Providers |
| N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
895742 | MS | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MS BOARD OF NURSING | 895742 | 01 |
| Street Address |
635 HAMPTON WAY APT C |
| City | JACKSON |
| State | MS |
| Zip Code | 39211-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025062 | Frederick Marvin Terry | Registered Nurse | 2135 Henry Hill Dr Ste 200, Jackson, MS 39204-2013 | 2020-08-28 |
| 1760091888 | Roshunda Sterling | Registered Nurse | 421 Hillandale Dr, Jackson, MS 39212-3204 | 2020-07-24 |
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1417585670 | Anna Cox | Registered Nurse | 1190 N State St Ste Ll01, Jackson, MS 39202-2413 | 2020-03-31 |
| 1588297873 | Kia Danielle Montgomery | Registered Nurse | 350 W Woodrow Wilson Ave Ste 411, Jackson, MS 39213-7681 | 2020-02-15 |
| 1922651744 | Jessica Marie Brown | Registered Nurse | 220 Summit St, Jackson, MI 49203-4667 | 2019-07-21 |
| 1366902413 | Theresa Louise Hendrick | Registered Nurse | 1410 4th St, Jackson, MI 49203-4030 | 2019-03-24 |
| 1508324302 | Erica Daliance Simmons | Registered Nurse | 2246 Wild Valley Dr, Jackson, MS 39211-6164 | 2019-03-11 |
| 1326529942 | Moshe Reich | Registered Nurse | 874 Bethel Church Rd, Jackson, NJ 08527-1712 | 2018-08-22 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 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.