BRENDA DARNETTA SHUTZ (NPI# 1942828942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942828942 |
| Entity Type | Individual |
| Full Name | BRENDA DARNETTA SHUTZ |
| Practice Address |
330b Highway 90 Gautier MS 39553-5744 |
| Mailing Address |
1505 Riverside Dr Gautier MS 39553-2850 |
| Practice Telephone | 2284970690 |
| Mailing Telephone | 2286233319 |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WR0400X |
Registered Nurse Specialization: Rehabilitation |
510505 | MS | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018214 | 05 |
| Street Address |
330B HIGHWAY 90 |
| City | GAUTIER |
| State | MS |
| Zip Code | 39553-5744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497309298 | Jaleesa Nicole Williams | Registered Nurse | 330b Highway 90, Gautier, MS 39553-5744 | 2019-07-30 |
| 1689281214 | Tamika Davis | Registered Nurse | 330b Highway 90, Gautier, MS 39553-5744 | 2020-09-28 |
| 1790393072 | Melba Richardson | Registered Nurse | 330b Highway 90, Gautier, MS 39553-5744 | 2020-07-22 |
| 1326656802 | Evelynn Malone Stephens | Registered Nurse | 330b Highway 90, Gautier, MS 39553-5744 | 2020-07-21 |
| 1013545128 | Sara Jane Adair | Registered Nurse | 330b Highway 90, Gautier, MS 39553-5744 | 2020-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205465044 | Loggan Malone | Dentist | 2808 Us-90 W, Gautier, MS 39553 | 2020-04-03 |
| 1770979775 | Catherine Durham | Counselor | 3407 Shamrock Dr., Gautier, MS 39553 | 2015-04-07 |
| 1851648836 | Pharmatex, LLC | Pharmacy | 4551-d Gautier Vancleave Road, Gautier, MS 39553 | 2012-08-09 |
| 1891957544 | David W Bonderer Dds Pllc | Dentist | 2808 Hwy 90, Suite 1, Gautier, MS 39553 | 2008-06-25 |
| 1790830313 | William D Parrish | Dentist | 713 Us Hwy 90, Gautier, MS 39553 | 2007-01-24 |
| 1073685830 | Jeffrey Lamone Knight | Dentist | 3105 Shaw Dr., Gautier, MS 39553 | 2006-11-15 |
| 1720178437 | Erica B Wilson | Counselor | 3704 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1881781631 | James D Victory | Chiropractor | 315 Highway 90, Gautier, MS 39553 | 2006-10-05 |
| 1508959180 | Robert Douglas Holbert | Internal Medicine | 2105 Old Spanish Trail, Gautier, MS 39553 | 2006-10-02 |
| 1962508119 | Sentry-gautier, Inc. | Nursing Facility/Intermediate Care Facility | 5090 Gautier Vancleave Road, Gautier, MS 39553 | 2006-09-15 |
| Find all providers in zip 39553 | ||||
| Taxonomy Code | 163WR0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Rehabilitation |
| Definition to come... |
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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.