KATELYN REBECCA MOFFETT (NPI# 1972875995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972875995 |
Entity Type | Individual |
Full Name | KATELYN REBECCA MOFFETT |
Credential | FNP-C |
Practice Address |
1102 Constitution Ave Meridian MS 39301-4001 |
Practice Telephone | 6016833117 |
Practice Fax Number | 6016832505 |
Mailing Telephone | 6017035600 |
Mailing Fax Number | 6017035691 |
Enumeration Date | 2012-02-07 |
Last Update Date | 2017-10-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R882198 | MS | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 04584751 | 05 |
Street Address |
1102 CONSTITUTION AVE |
City | MERIDIAN |
State | MS |
Zip Code | 39301-4001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952303778 | Regency Hospital Company of Meridian, LLC | Long Term Care Hospital | 1102 Constitution Ave, 2nd Floor, Meridian, MS 39301-4001 | 2005-08-11 |
1225566128 | Eva Nicole Dye | Nurse Practitioner | 1102 Constitution Ave, Meridian, MS 39301 | 2017-05-23 |
1285171074 | Rachel Temple | Nurse Practitioner | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2017-01-31 |
1336691112 | Lauren Elizabeth Kemp | Nurse Practitioner | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2016-10-27 |
1841665817 | Haley Gipson | Dietitian, Registered | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2015-12-02 |
1558784975 | Shannon Gibbs | Nurse Practitioner | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2014-01-22 |
1679916415 | Micah Ryan Morlas | Dietitian, Registered | 1102 Constitution Ave, Meridian, MS 39301 | 2013-04-11 |
1497016117 | Anderson Regional Medical Center | Psychiatric Unit | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2012-05-30 |
1164794178 | Heather Daye Bunyard | Nurse Practitioner | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2012-02-07 |
1114223880 | Anderson Regional Medical Center | Rehabilitation Unit | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2011-01-28 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
Find all providers in zip 39301 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104427152 | Christopher Alan Anthony Nicholas | Nurse Practitioner | 2889 N Chancery Pl, Meridian, ID 83646-7407 | 2020-11-05 |
1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
1649885534 | Auston Whitmer | Nurse Practitioner | 2203 E Ringneck St, Meridian, ID 83646-7410 | 2020-09-09 |
1407460157 | Kimberly N Lacap | Nurse Practitioner | 5961 Hwy 145, Meridian, MS 39301-9761 | 2020-09-01 |
1134733728 | Courtney S Dubose | Nurse Practitioner | 8252 Lizelia Rd, Meridian, MS 39305-8511 | 2020-09-01 |
1740890698 | Kimberly Parker | Nurse Practitioner | 4708 Hickory Hills Cir, Meridian, MS 39305-2440 | 2020-08-05 |
1396369138 | Tracy Ann Roberts | Nurse Practitioner | 3639 S Arno Ave, Meridian, ID 83642-1396 | 2020-06-06 |
1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
1285293639 | Lindsey Sand | Nurse Practitioner | 2347 E Gala St # 150, Meridian, ID 83642-4881 | 2019-06-10 |
Find all providers in MERIDIAN |
Please comment or provide details below to improve the information on KATELYN REBECCA MOFFETT.
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.