KATELYN REBECCA MOFFETT


Address: 1102 Constitution Ave, Meridian, MS 39301-4001
Phone: 6016833117

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
R882198 MS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MS 04584751 05

Office Location

Street Address 1102 CONSTITUTION AVE
City MERIDIAN
State MS
Zip Code 39301-4001

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City MERIDIAN
Zip Code 39301

Improve Information

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Dataset Information

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.

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