PRIMESOURCE NURSING SERVICES, INC (NPI# 1962573170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962573170 |
Entity Type | Organization |
Organization Name | PRIMESOURCE NURSING SERVICES, INC |
Practice Address |
38 Pass Rd Ste A Gulfport MS 39507-3107 |
Mailing Address |
Po Box 6705 Gulfport MS 39506-6705 |
Practice Telephone | 2288651330 |
Practice Fax Number | 2288651331 |
Mailing Telephone | 2288651330 |
Mailing Fax Number | 2288651331 |
Enumeration Date | 2006-11-10 |
Last Update Date | 2018-04-02 |
Authorized Official Name | MRS. RHETT M PLAUCHE (PRESIDENT) |
Authorized Official Telephone | 2288651330 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
7381 | MS | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
7381 | MS | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 06550237 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801987870 | Primesource Nursing Services, Inc | Nurse Practitioner | 4906 Kendall Ave, Gulfport, MS 39507-4409 | 2006-09-27 |
1114583994 | Primesource Nursing Services, Inc | Nurse Practitioner | 2279 Atkinson Rd, Biloxi, MS 39531-2209 | 2019-05-16 |
1952884652 | Primesource Nursing Services, Inc | Social Worker | 1500 Broad Ave, Gulfport, MS 39501-3601 | 2018-09-10 |
Street Address |
38 PASS RD STE A |
City | GULFPORT |
State | MS |
Zip Code | 39507-3107 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487673406 | Katherine P Griffis | Nurse Practitioner | 38 Pass Rd Ste A, Gulfport, MS 39507-3107 | 2006-07-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
Find all providers in zip 39507 |
Taxonomy Code | 363LG0600X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Gerontology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942711288 | Tiffany Sanders | Nurse Practitioner | 1340 Broad Ave Ste 420, Gulfport, MS 39501-2459 | 2017-10-13 |
1558872929 | Laura Rogers | Nurse Practitioner | 1340 Broad Ave Ste 300, Gulfport, MS 39501-2404 | 2017-10-12 |
1194925537 | Diane B Vaughn | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2007-07-24 |
1891711784 | Jeannine A Racey | Nurse Practitioner | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2006-07-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
1316500887 | Hollie Waldron | Nurse Practitioner | 408 Council Cir Ste C, Tupelo, MS 38801-4949 | 2019-04-19 |
1063975621 | Sheila Ann Frederick | Nurse Practitioner | 65 Patton Cemetary Rd, Fulton, MS 38843-9353 | 2019-04-10 |
1992263685 | Nadine Theresa James | Nurse Practitioner | 1214 Velma St, Hattiesburg, MS 39402-2751 | 2019-03-12 |
1396202396 | Roxane Theresa Moncure | Nurse Practitioner | 919 Rutherford Dr, Jackson, MS 39206-2033 | 2019-02-26 |
1750889416 | Katherine Bolden | Nurse Practitioner | 1666 Highway 19 S, Meridian, MS 39301-8209 | 2018-01-29 |
1306350129 | Tamika M Broome | Nurse Practitioner | 350 W Woodrow Wilson Ave # 411, Jackson, MS 39213-7681 | 2017-12-01 |
1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
1134589930 | Rebecca L. Cauthen | Nurse Practitioner | 885 Liberty Rd Ste 300, Flowood, MS 39232-9006 | 2016-03-07 |
1114399284 | Kristie G Jenkins | Nurse Practitioner | 2908 S Lamar Blvd, Suite 100, Oxford, MS 38655-5354 | 2015-10-28 |
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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.