Christopher Gully, NP | |
363 Southcrest Cir Ste 202, Southaven, MS 38671-4737 | |
(901) 226-0456 | |
(901) 226-0458 |
Full Name | Christopher Gully |
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Gender | Male |
Speciality | Nurse Practitioner - Gerontology |
Location | 363 Southcrest Cir Ste 202, Southaven, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1013778596 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 3555 (Tennessee) | Secondary |
363LG0600X | Nurse Practitioner - Gerontology | 906487 (Mississippi) | Primary |
Entity Name | Vascular And Vein Institute Of The South Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275016941 PECOS PAC ID: 9739423336 Enrollment ID: O20181210000856 |
Mailing Address | Practice Location Address |
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Christopher Gully, NP 965 Ridge Lake Blvd Ste 315, Memphis, TN 38120-9401 Ph: (877) 348-1281 | Christopher Gully, NP 363 Southcrest Cir Ste 202, Southaven, MS 38671-4737 Ph: (901) 226-0456 |
Mr. Nathaniel Levi Bump, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7900 Airways Blvd Ste 6, Southaven, MS 38671 Phone: 662-470-7549 Fax: 269-906-2006 | |
Ms. Sherlean D Shugars, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2149 Stateline Rd W, Southaven, MS 38671 Phone: 662-342-1112 | |
Penny Marie Holley, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3964 Goodman Rd E Ste 128-129, Southaven, MS 38672 Phone: 662-655-0456 Fax: 662-655-0457 | |
Mrs. Christy Le Anne Egbert, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Airways Pl, Southaven, MS 38671 Phone: 662-349-9990 Fax: 662-349-2620 | |
Misty Burton, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 391 Southcrest Cir, Southaven, MS 38671 Phone: 662-349-2659 | |
Rebecca Holly T Robertson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Airways Pl, Southaven, MS 38671 Phone: 662-349-9990 Fax: 662-349-2620 |